Donors after cardiocirculatory death and lung transplantation

İnci, İlhan

doi:10.21037/jtd.2017.07.82

Cited by 28 publications

(24 citation statements)

References 66 publications

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“…Lungs are the only organs that do not require circulation to maintain the aerobic cellular metabolism because of the mechanism of passive diffusion across the alveolar membrane. Adequate gas exchange has been shown after 2 h of WIT in the absence of lung circulation, 28 which is why most programs recommend a WIT <150 minutes and a maximum preservation time <240 minutes. 9,17 Our protocol initially shortened these limits up to 120 minutes and 180 minutes, respectively.…”

Section: Discussionmentioning

confidence: 99%

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

Suberviola

Mons

Ballesteros

et al. 2019

American Journal of Transplantation

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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 posttransplant outcomes. K E Y W O R D Sclinical research/practice, donation after circulatory death (DCD), donors and donation, lung transplantation/pulmonology, organ perfusion and preservation, organ procurement, organ procurement and allocation, transplant coordinator

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Section: Discussionmentioning

confidence: 99%

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

Suberviola

Mons

Ballesteros

et al. 2019

American Journal of Transplantation

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“…First of all, despite being a young non-smoker, our donor had a complicated past medical history which included direct and indirect injuries to the lungs: pulmonary embolism and cardiac diseases, respectively. Furthermore, he collapsed in a swimming pool and the bronchoscopic evaluation confirmed the presence of aspiration, which is considered a contraindication for the usage of lungs from DBD donors too [ 4 , 5 , 14 , 15 ]. The suitability of lungs from an uncontrolled DCD donor is established using stringent criteria, especially regarding ischemic time; however, the limit of tolerated ischemic time varies among different centres.…”

Section: Discussionmentioning

confidence: 99%

Extended-criteria uncontrolled DCD donor for a fragile recipient: A case report about a challenging yet successful lung transplantation

Musso

Mendogni

Scaravilli

et al. 2020

International Journal of Surgery Case Reports

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Highlights Lung donation after cardiac death is a valuable option to fight organ shortage. Grafts from an extended uncontrolled DCD donor were transplanted. The recipient was a high-risk fragile patient with cystic fibrosis. Ex-vivo lung perfusion has a pivotal role in graft function evaluation. Good results were achieved despite several relative contraindications.

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“…The International Society for Heart and Lung Transplantation (ISHLT) DCD working group recommended in 2015 six crucial time points in the DCD process ( Fig. 1) [5,20].…”

Section: Definition Of Donation After Circulatory Death Timingsmentioning

confidence: 99%

“…It was shown that universal identification of potential DCD donors could increase LTx activity by 50%, which would result in a virtual elimination of the waiting-list [7]. Although countries like the United Kingdom, Australia, Belgium and the Netherlands reached a high percentage of DCD donors, a continuous global underutilization is noticed [5,8,9]. In 2018, the OPTN reported that only 6.6% (n ¼ 169) of all LTx (n ¼ 2542) came from DCD, within Eurotransplant DCD utilization accounted for 5% (n ¼ 62) of all LTx in 2017 (n ¼ 1233) [10,11].…”

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confidence: 99%

Lung donation after circulatory death

Ceulemans

İnci

Raemdonck

2019

Current Opinion in Organ Transplantation

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PURPOSE OF REVIEW The current review presents a concise update on published literature on donation after circulatory death (DCD) and lung transplantation (LTx). Worldwide an increasing need for lungs is evident, however the utilization rate of DCD lung donors is still considerably low. In this summary article, we reviewed both the experimental background and international clinical experience. RECENT FINDINGS Our analysis confirmed satisfactory results for LTx from DCD donors, which equals the results from donation after brain death. Although most studies reported on short-term results, some confirmed these results on the long-term and development of chronic lung allograft dysfunction. Our review summarizes the different DCD categories and underlines the potential of the DCD V category. We analyze the barriers to implement a DCD program, discuss the more recent advances like ex-vivo lung perfusion and describe the future challenges. SUMMARY Based on the current short-term and long-term clinical results, we believe that barriers for DCD utilization should be overcome, resulting in a safe implementation of more DCD LTx programs worldwide. VIDEO ABSTRACT.

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Donors after cardiocirculatory death and lung transplantation

Cited by 28 publications

References 66 publications

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

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

Extended-criteria uncontrolled DCD donor for a fragile recipient: A case report about a challenging yet successful lung transplantation

Lung donation after circulatory death

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