Donor Lung Selection Criteria and Surgical Application at University of Pittsburgh

Abstract

Lung transplantation is the standard treatment for patients with end-stage lung disease. Unfortunately scarce source of donor organs, particularly in lungs, limits this selected treatment to very few recipients each year. To decrease waiting list deaths and provide organs to more diverse recipient population, widening selection criteria of donor lungs was offered. Besides expanded criteria in organ selection to increase lung transplant surgery, donation after cardiac death and ex-vivo lung perfusion were introduced to current medicine. University of Pittsburgh in last decade doubled its lung transplant volume by extending the acceptance criteria for donor lungs for which many other centers would decline in first line or some selected centers may try ex-vivo perfusion protocols on these lungs. Nonetheless successful transplant surgery requires successful donor procurement surgery. Based on this practice, we wanted to review the Pittsburgh model of expanding lung donor selection criteria and surgery for donor lung procurement.