Abstract
Purpose Many international programs have developed extended criteria to increase availability of donor lungs with good overall utilization. Usage of Public Health Service (PHS) Increased Risk Donors (IRD) in lung transplantation (LTx) in the US remains low despite limited donor availability and protracted wait times. We sought to examine the incidence of IRD use in the US and evaluate the impact of IRD on post-LTx outcomes in a large national registry. Methods 23,090 patients receiving LTx from either a Standard Risk Donor (SRD) (19,897) or PHS IRD (3193) were identified from the UNOS Registry from 1987 to 2018. Exclusions included age Results A mere 16% of LTx recipients received a PHS IRD during the study period. Recipients of IRD tended to be male, older than those receiving SRD (p Conclusion Use of PHS IRD is associated with reduced waitlist time and is not associated with increased graft failure, rejection, infection, malignancy, or BOS. Notwithstanding, utilization of IRD remains low. Further study is warranted to determine and remedy the remaining barriers to IRD utilization.
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