Excellent long-term outcome with lungs obtained from uncontrolled donation after circulatory death - 190212

Suberviola B1, Mons R2, Ballesteros MA1, Mora V3, Delgado M4Naranjo S2, Iturbe D3, Miñambres E1,5. (University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain

Am J Transplant. 2018 Dec 23. doi: 10.1111/ajt.15237. [Epub ahead of print]

We aimed to propose a simple and effective preservation method in lungs procured for transplantation from uncontrolled donation after circulatory death (uDCD) associated with excellent long-term results. Outcome measures for lung recipients were survival and primary graft dysfunction (PGD) grade 3. Survival was estimated using the Kaplan-Meier method. A total of 9 lung uDCDs were evaluated and 8 lung transplants were performed. Mean no flow time was 9.8 minutes (standard deviation [SD] 8.6). Mean time from cardiac arrest to topical cooling was 96.8 minutes (SD 16.8). Preservation time was 159 minutes (SD 31). Ex vivo lung perfusion was used to assess lung function prior to transplantation in 2 cases. Mean recipient age was 60.8 years (SD 3.1), and mean total ischemic time was 678 minutes (SD 132). PGD grade 3 was observed in 2 cases (25%). The 1-month, 1-year and 5-year survival rates were 100%, 87.5% and 87.5%, respectively. Mean follow-up was 52 months. The logistic complexity of procuring lungs from uDCDs for transplantation requires the development of new strategies designed to facilitate this type of donation. A program based on strict selection criteria, using a simple and effective preservation technique, may recover lung grafts with excellent long-term post-transplant outcomes.

This article is protected by copyright. All rights reserved. PMID: 30582287 DOI: 10.1111/ajt.15237