Morbidity and Mortality of Live Lung Donation: Results From the RELIVE Study

• Published in: American journal of transplantation Vol. 14; no. 8; pp. 1846 - 1852
• Main Authors: Yusen, R. D., Hong, B. A., Messersmith, E. E., Gillespie, B. W., Lopez, B. M., Brown, K. L., Odim, J., Merion, R. M., Barr, M. L.
• Format: Journal Article
• Language: English
• Published: Hoboken, NJ Wiley 01-08-2014; Elsevier Limited
• Subjects: Adolescent; Adult; Biological and medical sciences; Cohort Studies; Databases, Factual; Epidemiology; Female; General aspects; Humans; Length of Stay; Live donors; Living Donors - statistics & numerical data; Lung - surgery; Lung Diseases - mortality; Lung Diseases - surgery; Lung Transplantation; Male; Medical sciences; Middle Aged; Morbidity; mortality; outcomes; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality Control; Research Design; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Transplants & implants; Treatment Outcome; Young Adult; USA, California; USA, Washington; Prognosis; Live donors; Living donor; Mortality; Lung; Transplantation; Homotransplantation; Respiratory system; Epidemiology; Morbidity; Result; Treatment; outcomes; Surgery; Graft; Evolution; lung transplantation
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/ajt.12771

The Renal and Lung Living Donors Evaluation Study assesses outcomes of live lung (lobectomy) donors. This is a retrospective cohort study at University of Southern California (USC) and Washington University (WASHU) Medical Centers (1993–2006), using medical records to assess morbidity and national databases to ascertain postdonation survival and lung transplantation. Serious complications were defined as those that required significant treatment, were potentially life‐threatening or led to prolonged hospitalization. The 369 live lung donors (287 USC, 82 WASHU) were predominantly white, non‐Hispanic and male; 72% had a biological relationship to the recipient, and 30% were recipient parents. Serious complications occurred in 18% of donors; 2.2% underwent reoperation and 6.5% had an early rehospitalization. The two centers had significantly different incidences of serious complications (p < 0.001). No deaths occurred and no donors underwent lung transplantation during 4000+ person‐years of follow‐up (death: minimum 4, maximum 17 years; transplant: minimum 5, maximum 19). Live lung donation remains a potential option for recipients when using deceased donor lungs lacks feasibility. However, the use of two live donors for each recipient and the risk of morbidity associated with live lung donation do not justify this approach when deceased lung donors remain available. Center effects and long‐term live donor outcomes require further evaluation.
This retrospective study of 369 live lung donors shows an 18% short‐term incidence of serious complications and no short‐ or long‐term mortality, and suggests a need for long‐term evaluation of morbidities and other important outcomes.