Multicenter Study of Inflammation Markers in Lung Transplant (LT): Comparison of Donation after Cardiac Death (cDCD) and Brain Death (DBD) DACMECITOS Study

Abstract

Our objective is to compare the inflammatory response pattern of lungs transplanted from DBD and cDCD donors. Eighty adult lung recipients, 40 from DBD and 40 from cDCD donors (paired by LT indication and age) were prospectively enrolled in 4 Spanish transplant centres from Jul-18 to Jul-19. Data from donors and recipients as well as transplant procedure were analyzed. Blood samples were collected from the donor before (E0) and during the retrieval process (E1), and from the recipient before implant (R-1), after graft reperfusion (R0) and 24(R24)/ 48(R48) and 72(R72) hours after LT. Inflammatory response (IL-6, IL-8, IL-10, TNF-α) was compared between groups. Demographics of donors and recipients as well as transplant surgical procedure characteristics were similar between groups except for a higher rate of corticoid treatment and vaso-active support in DBD donor group and higher blood transfusion requirements in cDCD donor group (Table 1). DBD donors presented higher IL6 and IL10 plasma levels (p<0.001), and recipients from DBD donors showed higher plasma levels of IL10 and TNFa at 72h after transplantation (p<0.05) (Figure 1). Controlled DCD triggers a lower inflammatory response than DBD that may also influence the inflammatory pattern in the recipient. cDCD is a safe alternative to DBD in lung transplantation.