Lung Transplantation from Donation after Cardiac Death – 3 Years Single Centre Experience

Abstract

Purpose This study evaluates the short term outcomes of donation after cardiac death (DCD) Lung recipients at our institution. Methods and Materials 69 lung transplantations were performed between September 2009 and September 2012. A total of 60 lungs were transplanted from donation after brain stem death (DBD) and 9 from DCD donors. DCD Donor and recipient characteristics are presented in Table 1 and Table 2 respectively. Results Overall survival for DCD group was 100% and 88.8% respectively at 1 and 3 years and one patient died at 19 month. No recipient developed primary graft dysfunction or airway complications. 4 patients (44.4%) required tracheostomy and prolonged ventilation. Median time to extubation, intensive care unit stay and total hospital stay were 6, 11, 23 days respectively. Cumulative survival for DCD and DBD groups was not statistically significant (p = 0.243). [ figure 1 ] The freedom from BOS at 1, 2 and 3 years was 100%, 77.7% and 55.5% respectively. Conclusions No patient had primary graft dysfunction or airway complications in our early experience, which is very promising. We therefore suggest, the donor pool should be expanded by using lungs from DCD donors to meet the ever growing demand of lung transplantation and they can contribute to reduce waiting list deaths. Age(yrs) 39.4±2.7 Sex(female) 7(77.7%) Cause of death: CVA 8(89%) Head Trauma 1(11%) Best PaO2/FiO2 Ratio 463±54.3 Time from withdrawal to cardiac arrest(min) 17±11.5 Warm ischaemic time(min) 17±7.5 Age(yrs) 43.2±11.2 Sex(female) 4(44.4%) Diagnosis: COPD 5(55%) Cystic fibrosis 1(11%) Idiopathic pulmonary fibrosis 2(22%) Total ischaemic time(min) 381±70