IL-1β in broncho-alveolar lavage is a non-invasive predictor of the viability of the pulmonary graft from the non-heart-beating donor

Abstract

donors have focused on short-term (1 year) outcome. We previously published the 1-year outcomes and short-term complications associated with the use of extended donors. We now present data on follow-up of these patients three years after transplantation. Methods: One hundred thirteen patients underwent lung transplantation at our institution between 1996 and 1999. Patients were categorized as receiving lungs from either ideal or extended donors. An extended donor was defined as having any one of the following: donor age 55 years; tobacco history 20 pack years; radiographic infiltrates; mechanical ventilation 5 days; or donor use of inhaled drugs (cocaine or marijuana). The groups were compared for the development of bronchiolitis obliterans syndrome (BOS), the severity of BOS and 3-year post-transplant survival. Results: Sixty-one (54%) patients received lungs from ideal donors and 52 (46%) patients received lungs from extended donors. BOS developed in 6/61 (10%) patients in the ideal group and 10/52 patients (20%) in the extended group (p ns). The mean time to development of BOS was 22 13 months in the ideal group compared to 17 12 months in the extended group (p ns). Three patients (5%) in the ideal group developed BOS grade 2 or higher compared to 7/52 (13%) patients in the extended group (p ns). There was no difference in the 3-year survival between the groups (44%vs.60%; p ns) Conclusions: The use of extended donors is not associated with the development of BOS or increased mortality at three years after transplantation. This data supports reevaluation of the current guidelines for lung donor criteria.