Extended Criteria Donors; a Safe Way To Expand the Lung Donor Pool?

Abstract

Purpose Although the worldwide need to expand the lung donor pool, 75 % of multi-organ donors are discarded for lung transplantation (LTx). Herein, we report the outcome of liberalizing standard lung donor criteria. Methods and Materials All effective heart-beating lung donors within our hospital network between 2000 and 2010 (n=449) were classified as standard (SCD, n=284) or extended (ECD, n=149) criteria donors according to age (>55years), P/F ( Results Short-term outcome demonstrated significant differences in ICU stay ( p =0.03), PGD T12 ( p =0.003), T24 ( p =0.009) and T48 ( p =0.03) but not for time to extubation ( p =0.28). No significant differences were seen in long-term outcome like acute rejection ( p =0.84), chronic rejection ( p =0.18) and 10-year survival ( p =0.33, Figure A). Adding donor smoking status resulted in similar findings. Significant differences remained in short-term outcome like PGD T12( p =0.001), T24( p =0.001) and T48( p =0.001), extubation time ( p =0.04), ICU stay ( p =0.02) was observed. While no differences were found for long-term outcome as acute rejection ( P =0.85), chronic rejection ( p =0.54) and survival ( p =0.72, Figure B). Conclusions Although, transplanting ECD lungs has an impact on the early post-operative outcome after LTx, even more pronounced for lungs from smokers, liberalization of lung donor criteria did not negatively influence long-term outcome after LTx.