Mechanical Ventilatory Support in Potential Lung Donor Patients

Bansal, Ruchi; Esan, Adebayo; Hess, Dean; Angel, Luis F.; Levine, Stephanie M.; George, Tony; Raoof, Suhail

doi:10.1378/chest.12-2745

Cited by 20 publications

(21 citation statements)

References 37 publications

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“…Fibre optic bronchoscopy is routinely performed on the donor, not only to visually inspect the major airway, but also to collect a bronchial washing sample to help guide the recipient's antimicrobial regimen. In order to optimise gas exchange, enhance alveolar recruitment and protect the lungs before procurement, the intensive care unit will instigate targeted ventilation strategies which have been shown to improve organ utilisation rates 35 . ‐ 39 The time from acceptance of donor organs to procurement may be many hours or even days, stressing the importance of close monitoring and regular assessment.…”

Section: Donor Evaluation and Managementmentioning

confidence: 99%

Lung transplantation in Australia, 1986–2018: more than 30 years in the making

Paraskeva

Levin

Westall

et al. 2018

Medical Journal of Australia

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Lung transplantation in Australia is 32 years old in 2018. From its early infancy in 1986, it continues to evolve and is internationally recognised as demonstrating world's best practices in organ donation, utilisation and transplantation procedures. Over the past decade, transplant numbers have increased substantially due to innovations in donor procurement, such as donation after circulatory death, the use of ex vivo lung perfusion, extended criteria and organ utilisation, with more than 200 lung transplants undertaken in Australia annually. Parallel to this, lung transplant outcomes have continued to improve. While the management of lung transplant recipients is heavily dependent on a tertiary care paradigm, this model is well developed and has been extremely successful, with Australian outcomes exceeding those of the International Society for Heart and Lung Transplantation Registry at all time points.

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Section: Donor Evaluation and Managementmentioning

confidence: 99%

Lung transplantation in Australia, 1986–2018: more than 30 years in the making

Paraskeva

Levin

Westall

et al. 2018

Medical Journal of Australia

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“…20 In 2009, a multicenter randomized controlled trial comparing a lung protective ventilation (LPV) strategy with conventional ventilation strategies in DBD donors showed that an LPV strategy improved the preharvest PaO 2 /FiO 2 ratio in comparison with conventional ventilation practices. 21,22 The recommended ventilation strategy for donors ( Table 5) 23 suggests that appropriate LPV plays an important role in attenuating lung injury and optimizing donor lungs.…”

Section: Donation After Determination Of Cardiac Deathmentioning

confidence: 99%

New Techniques for Optimization of Donor Lungs/Hearts

Braithwaite

Kaaij

2019

Anesthesiology Clinics

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Lung transplantation is at present the only life-prolonging therapy for end-stage lung failure or end-stage vascular lung disease. A wide range of pathologic lung conditions can progress with varying speed to a situation whereby lung function can no longer support life. Affected patients benefit from lung transplantation, the use of lung allografts from deceased patients to replaced diseased lung(s) in the recipient. Owing to advances in surgical technique, perioperative support, and immunosuppressive therapies, lung transplantation is now an accepted and widely used Disclosure Statement: Both authors have no disclosures.

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“…Injury can result from trauma, complications of mechanical ventilation, or aspiration. Several donor lung management strategies are widely practiced, including well-described intensive care ventilation and bronchoscopic strategies 46,50 and EVLP. 51 The Changing Landscape of Donor Acceptability ►Table 3 provides a snapshot of common historical acceptability criteria, and how these have transformed over time.…”

Section: "Extended" Donor Considerations and 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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Mechanical Ventilatory Support in Potential Lung Donor Patients

Cited by 20 publications

References 37 publications

Lung transplantation in Australia, 1986–2018: more than 30 years in the making

Lung transplantation in Australia, 1986–2018: more than 30 years in the making

New Techniques for Optimization of Donor Lungs/Hearts

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

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