Lung transplantation using controlled donation after circulatory death donors: Trials and tribulations

Cypel, Marcelo; Levvey, Bronwyn; Raemdonck, Dirk Van; Erasmus, Michiel E.; Dark, John H.; Mason, David P.; Glanville, Allan R.; Chambers, D.C.; Edwards, Leah B.; Stehlik, Josef; Hertz, Marshall I.; Whitson, B.A.; Yusen, Roger D.; Hopkins, P.; Snell, Greg; Keshavjee, Shaf

doi:10.1016/j.healun.2015.10.004

Cited by 35 publications

(26 citation statements)

References 5 publications

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“…Failure to meet the criteria to become an organ donor occurs in approximately 40% of cases. 79,80 A number of algorithms have been developed to attempt to predict likelihood of progression 81,82 but lack usefulness because of their inaccuracy. From the International Society for Heart and Lung Transplant DCD registry, the median time from withdrawal of life support therapy (WLST) to arrest is 15 min and from WLST to cold perfusion (warm ischemic time) is 30 min.…”

Section: Donation After Circulatory Death For Lung Procurementmentioning

confidence: 99%

Donor heart and lung procurement: A consensus statement

Copeland

Hayanga

Neyrinck

et al. 2020

The Journal of Heart and Lung Transplantation

119

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Section: Donation After Circulatory Death For Lung Procurementmentioning

confidence: 99%

Donor heart and lung procurement: A consensus statement

Copeland

Hayanga

Neyrinck

et al. 2020

The Journal of Heart and Lung Transplantation

119

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“…Reasons for this underutilization are multifactorial. The ISHLT DCD working group reported that 85% of the participants mentioned complex logistics and absence of DCD-related protocols as the primary reasons for not using DCD [52]. Other barriers are regulations, fear of public disapproval, lack of surgical expertise, lung quality concerns, declined premortem evaluation, inability to evaluate lungs in a controlled fashion, financial challenges and possibility of aborted procurement [53].…”

Section: Clinical Experiencementioning

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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“…The steps to accessing this expanded DCD pool include the development of collaborative local and jurisdictional DCD guidelines. 2,80,81 Staff education at the transplant team, ICU, operating room, and organ procurement organizational levels is also critical.…”

Section: Future Directions In Lung Donor Managementmentioning

confidence: 99%

Donation after Brain Death versus Donation after Circulatory Death: Lung Donor Management Issues

Snell

Levvey

Levin

et al. 2018

Semin Respir Crit Care Med

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Lung transplantation (LTx) has traditionally been limited by a lack of suitable donor lungs. With the recognition that lungs are more robust than initially thought, the size of the donor pool of available lungs has increased dramatically in the past decade. Donation after brain death (DBD) and donation after circulatory death (DCD) lungs, both ideal and extended are now routinely utilized. DBD lungs can be damaged. There are important differences in the public's understanding, legal and consent processes, intensive care unit strategies, lung pathophysiology, logistics, and potential-to-actual donor conversion rates between DBD and DCD. Notwithstanding, the short- and long-term outcomes of LTx from any of these DBD versus DCD donor scenarios are now similar, robust, and continue to improve. Large audits suggest there remains a large untapped pool of DCD (but not DBD) lungs that may yet further dramatically increase lung transplant numbers. Donor scoring systems that might predict the donor conversion rates and lung quality, the role of ex vivo lung perfusion as an assessment and lung resuscitation tool, as well as the potential of donor lung quality biomarkers all have immense promise for the clinical field.

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Lung transplantation using controlled donation after circulatory death donors: Trials and tribulations

Cited by 35 publications

References 5 publications

Donor heart and lung procurement: A consensus statement

Donor heart and lung procurement: A consensus statement

Lung donation after circulatory death

Donation after Brain Death versus Donation after Circulatory Death: Lung Donor Management Issues

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