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Lung Transplantation with Controlled Donation after Circulatory Death Donors


Inci, Ilhan; Hillinger, Sven; Schneiter, Didier; Opitz, Isabelle; Schuurmans, Macé; Benden, Christian; Weder, Walter (2018). Lung Transplantation with Controlled Donation after Circulatory Death Donors. Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia, 24(6):296-302.

Abstract

PURPOSE Utilization of donation after circulatory death (DCD) donors has the potential to decrease donor shortage in lung transplantation (LTx). This study reviews the long-term outcome of LTx from DCD donors. METHODS We included all consecutive DCD (Maastricht Category III) and all donations after brain death (DBD) donor lung transplants at our Center performed between January 2012 and February 2017. Data were analyzed comparing the two groups in regard of survival after LTx as primary outcome. RESULTS Median withdrawal to cardiac arrest time was 17 min (interquartile range [IQR]: 11.5-20.5). Median cardiac arrest to cold perfusion was 32 min (IQR: 24.5-36.5). Primary graft dysfunction (PGD) grade 3 at T72 occurred in three recipients. Chronic lung allograft dysfunction (CLAD) led to death in two cases. In DCD group, there was no 90-day mortality. In DCD, group 1- and 3-year survival rates were 100% and 80%. In DBD group, 1- and 3-year survival rates were 85% and 69% (p = 0.4). CONCLUSIONS Our report confirmed the comparable outcome from DCD donors compared with DBD donors. Utility of DCD donors is a safe option to overcome donor shortage.

Abstract

PURPOSE Utilization of donation after circulatory death (DCD) donors has the potential to decrease donor shortage in lung transplantation (LTx). This study reviews the long-term outcome of LTx from DCD donors. METHODS We included all consecutive DCD (Maastricht Category III) and all donations after brain death (DBD) donor lung transplants at our Center performed between January 2012 and February 2017. Data were analyzed comparing the two groups in regard of survival after LTx as primary outcome. RESULTS Median withdrawal to cardiac arrest time was 17 min (interquartile range [IQR]: 11.5-20.5). Median cardiac arrest to cold perfusion was 32 min (IQR: 24.5-36.5). Primary graft dysfunction (PGD) grade 3 at T72 occurred in three recipients. Chronic lung allograft dysfunction (CLAD) led to death in two cases. In DCD group, there was no 90-day mortality. In DCD, group 1- and 3-year survival rates were 100% and 80%. In DBD group, 1- and 3-year survival rates were 85% and 69% (p = 0.4). CONCLUSIONS Our report confirmed the comparable outcome from DCD donors compared with DBD donors. Utility of DCD donors is a safe option to overcome donor shortage.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Pneumology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Thoracic Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:20 December 2018
Deposited On:03 Jan 2019 11:51
Last Modified:01 Feb 2019 10:56
Publisher:Japanese Editorial Committee of Annals of Thoracic and Cardiovascular Surgery
ISSN:1341-1098
OA Status:Green
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.5761/atcs.oa.18-00098
PubMed ID:29962390

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