Use of donors who have suffered cardiopulmonary arrest and resuscitation in lung transplantation☆

Abstract

Shortage of donors is one of the major limitations in lung transplantation (LuTX) and an aggressive expansion of criteria for donor selection has been proposed. This study evaluates the outcome of recipients of pulmonary grafts coming from resuscitated donors when compared with recipients of non-resuscitated donors. We retrospectively analyzed the donor and recipient charts of all double LuTX performed at our institution between 2000 and 2008 with regard to the performance of donor-cardiopulmonary resuscitation (CPR). Out of 186 eligible transplants, 22 patients (11.8%) received lungs from donors who have suffered cardiac arrest (CA) and subsequent CPR. Mean duration of CPR was 15.2 ± 11.3 min. Terminal laboratory profiles of CPR donors and non-CPR donors were similar as were ventilation time and paO(2)/FiO(2) ratio before organ harvesting or chest X-ray. CPR-donor status did not affect the following indices of graft function: length of postoperative ventilation, paO(2)/FiO(2) ratio up to 48 h and lung function up to 60 months. Length of intensive care and hospital stay, need for inotropic support and 30-day mortality were not significantly different for the transplantation of CPR or no-CPR donor lungs. One- and 3-year survival rates were comparable as well with 84.4% and 66.3% for CPR donors versus 88.5% and 69.8% no-CPR donors. This study indicates that transplantation of lungs from resuscitated donors may not affect outcome after LuTX. Therefore, donor history of CA should not automatically preclude LuTX.