Latest UNOS data confirms comparable survival after DCD and DBD lung transplantation
As previously noted in Insights(1), many lung transplantation centers have reported similar post-transplant outcomes, including primary graft dysfunction (PGD) and survival, between recipients of lungs donated after circulatory death (DCD) and those donated after brain death (DBD). The donor pool could be increased if DCD lungs were used more.
A recent UNOS(2) data-mining report from the Boston group (Villaviciencio et al, 2018)(3) now confirms that five- and ten-year survival after DCD and DBD lungs are indeed virtually comparable, but despite this, overall utilization of DCD lungs in USA is still remarkably low: only 2% of all lungs (389 of 20,905) transplanted in 2017 were DCD lungs.
Some pioneering centers, however, including Boston (where 12% were DCD lungs) have substantially higher DCD ratios. In Boston, propensity-matched analysis of 311 DBD/DCD pairs confirmed comparable survival but also revealed similar risks for PGD at 24, 48 and 72 hours after transplantation.
The 2017 UNOS data also shows the number of lung transplants continues to increase but that the need for organs is still outpacing available donors. Although use of DCD lungs is now rising in both USA and Europe, they are still clearly underutilized.
2. Valapour M1,2, et al, Am J Transplant. 2019 Feb;19 Suppl 2:404-484. doi: 10.1111/ajt.15279. OPTN/SRTR 2017 Annual Data Report: Lung. (link to abstract)
3. Villavicencio MA et al, Ann Thorac Surg. 2018 Dec;106(6):1619-1627. doi: 10.1016/j.athoracsur.2018.07.024. Lung Transplantation From Donation After Circulatory Death: United States and Single-Center Experience. (link to abstract)
Xvivo Insights PB-2019-03-26