Time from Organ Donation Referral to Procurement Does Not Affect Survival in Lung Transplant Recipients

Abstract

A recent study showed increasing the time from referral to procurement for donor hearts increases mortality for heart transplant recipients. The purpose of this study is to look at the effect of the interval from referral to procurement on mortality in lung transplant recipients. The United Network for Organ Sharing (UNOS) database was retrospectively reviewed from 01/2007-03/2018 for donor lungs. After exclusions for multi-organ transplants and age (donor <15 years(y), recipient <18y); 18,986 recipients had lung transplants. The primary outcome was 3-year survival. Modeling was done via random survival forests and Weibull regression. Donor age ranged from 15-77y (mean 35y, median 33y) and recipient age from 18-81y (mean 56y, median 59y). Sixty percent of donors were male as were recipients. Seventy percent of transplants were double lung transplants. Neither time from referral to procurement nor admission to procurement of the donor is a significant predictor for survival for lung recipients using either modeling approach (p-values ≥0.18 using Weibull regression and relative importance ≤0.003 compared to a maximum relative importance of 1.00 for recipient length of stay (LOS) post-transplant using random forests). Recipient LOS, age, and serum creatinine at the time of transplant as well as the number of previous lung transplants are the most important predictors of 3-year survival for lung transplant recipients. The time from referral to procurement and from admission to procurement of lung transplant donors does not affect recipient survival.