Impact of Donor Quality on Recipient Outcomes in Lung Transplantation: 10-year Single-Center Experience Using the Eurotransplant Lung Donor Score

Abstract

Purpose Although use of extended-criteria donor organs (ECD) has increased in lung transplantation, their impact on outcomes remains unclear. The Eurotransplant (ET) lung donor score (ELDS) was designed to classify lung donor quality, taking into account donor history, tobacco exposure, age, arterial blood gases, chest x-ray and bronchoscopic findings. This retrospective single-center study evaluates the impact of ECD on graft function and survival. Methods Records of lung allograft recipients transplanted at our institution between 01/2010 and 10/2020 were reviewed. Individual ELDS were calculated from the corresponding ET donor reports. Outcomes were compared between recipients of ideal donors (ELDS 6, Group 1), of intermediate-risk donors (ELDS 7-8, Group 2), and of extended-criteria donors (ELDS 9-15, Group 3). Median (IQR) follow-up was 46 (20-77) months. Results In total, 238/1,283 (19%) patients received Group 1 donor organs, 651 (51%) patients Group 2 donor organs, and 394 (30%) patients Group 3 donor organs. Group 2 and 3 recipients were older than group 1 recipients (median age, 52 and 54 vs. 43 years, p Conclusion ECD lungs constituted one third of our donor pool. Their use did not negatively impact the recipient survival, but CLAD-free survival was worse in ECD recipients.