Medium-term outcome after lung transplantation is comparable between brain-dead and cardiac-dead donors

Vleeschauwer, Stéphanie I. De; Wauters, Shana; Dupont, Lieven; Verleden, Stijn E.; Willems-Widyastuti, Anna; Vanaudenaerde, Bart M.; Verleden, Geert M.; Raemdonck, Dirk Van

doi:10.1016/j.healun.2011.04.014

Cited by 72 publications

(63 citation statements)

References 27 publications

(30 reference statements)

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“…While most of the programs reporting experience with DCDD lungs limit the WLST to arrest interval to 60 minutes (9,10,23,24), with the advent of EVLP we elected to extend the waiting upper limit of 120 minutes. Although our experience in this scenario is limited, we did transplant 3 cases of long (>60 minutes) interval between WLST and arrest.…”

Section: Dcdd-no Evlp Vs Dcdd þ Evlpmentioning

confidence: 99%

Lung Transplantation With Donation After Circulatory Determination of Death Donors and the Impact of Ex Vivo Lung Perfusion

Machuca

Mercier

Collaud

et al. 2015

American Journal of Transplantation

127

116

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The growing demand for suitable lungs for transplantation drives the quest for alternative strategies to expand the donor pool. The aim of this study is to evaluate the outcomes of lung transplantation (LTx) with donation after circulatory determination of death (DCDD) and the impact of selective ex vivo lung perfusion (EVLP). From 2007 to 2013, 673 LTx were performed, with 62 (9.2%) of them using DCDDs (seven bridged cases). Cases bridged with mechanical ventilation/extracorporeal life support were excluded. From 55 DCDDs, 28 (51%) underwent EVLP. Outcomes for LTx using DCDDs and donation after neurological determination of death (DNDD) donors were similar, with 1 and 5-year survivals of 85% and 54% vs 86% and 62%, respectively (p ¼ 0.43). Although comparison of survival curves between DCDD þ EVLP vs DCDD-no EVLP showed no significant difference, DCDD þ EVLP cases presented shorter hospital stay (median 18 vs. 23 days, p ¼ 0.047) and a trend toward shorter length of mechanical ventilation (2 vs. 3 days, p ¼ 0.059). DCDDs represent a valuable source of lungs for transplantation, providing similar results to DNDDs. EVLP seems an important technique in the armamentarium to safely increase lung utilization from DCDDs; however, further studies are necessary to better define the role of EVLP in this context.

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Section: Dcdd-no Evlp Vs Dcdd þ Evlpmentioning

confidence: 99%

Lung Transplantation With Donation After Circulatory Determination of Death Donors and the Impact of Ex Vivo Lung Perfusion

Machuca

Mercier

Collaud

et al. 2015

American Journal of Transplantation

127

116

View full text Add to dashboard Cite

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“…To date there is no clinical study to compare pre-mortem heparin use versus no heparin use. There are some centers that use pre-mortem heparin in a potential DCD donor (17,20,23,24,28,60,63). However some centers do not use premortem heparin (19,21,26,59).…”

Section: Donor Selection Criteria Cdcd Donorsmentioning

confidence: 99%

“…A recent International Society for Heart and Lung Transplantation (ISHLT) DCD Registry Report included 306 recipients among ten centers worldwide (12). Several centers published their experience, most of them with excellent or at least equal results compared to brain-dead donors (5,14,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28).…”

Section: Introductionmentioning

confidence: 99%

Donors after cardiocirculatory death and lung transplantation

İnci

2017

J. Thorac. Dis.

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Abstract:The number of patients actively awaiting lung transplantation (LTx) is more than the number of suitable donor lungs. The percentage of lung retrieval rate is lower when compared to other solid organs.The use of lungs from donation after cardiocirculatory death (DCD) donors is one of the options to avoid organ shortage in LTx. After extensive experimental research, clinical application of DCD donation is becoming wider. The results from most of the centers show at least equal survival rate compared to donors from brain death. This review paper will summarize experimental background and clinical experience from DCD donors.

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“…Lung transplantation with cDCDD compared with DBDD shows comparable patient survival (14,17), with a tendency toward lower graft survival (14) and a higher incidence of bronchiolitis obliterans syndrome (17). Heart transplantation from cDCDD remains anecdotal (16).…”

Section: Does the Use Of Ecmo In Cdcdd Programsmentioning

confidence: 99%

Ethical Issues in the Use of Extracorporeal Membrane Oxygenation in Controlled Donation After Circulatory Determination of Death

Ave¹,

Shaw

Bernat

2016

American Journal of Transplantation

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The use of donor extracorporeal membrane oxygenation (ECMO) to improve graft outcomes by some controlled donation after circulatory determination of death (cDCDD) programs raises ethical issues. We reviewed cDCDD protocols using ECMO and the relevant ethics literature to analyze these issues. It is not obvious that ECMO in cDCDD improves graft outcomes. In our opinion, ECMO implemented before death can interfere with end-of-life care and damage bodily integrity. By restoring systemic circulation, ECMO risks invalidating the preceding declaration of death if brain and cardiac perfusion is not adequately excluded because of malfunction or misplacement of the supradiaphragmatic aortic occlusion balloon. The use of ECMO is not compatible with the acronym DCDD because circulation is restored after the determination of death. Because of these deficiencies, we concluded that other techniques are preferable, such as rapid recovery or in situ cold infusion. If ECMO is performed, it requires a specific informed consent and transparency.Abbreviations: cDCDD, controlled donation after circulatory determination of death; DBDD, donation after brain determination of death; DBTL, doubleballoon triple-lumen; DCDD, donation after circulatory determination of death; DDR, dead donor rule;

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Medium-term outcome after lung transplantation is comparable between brain-dead and cardiac-dead donors

Cited by 72 publications

References 27 publications

Lung Transplantation With Donation After Circulatory Determination of Death Donors and the Impact of Ex Vivo Lung Perfusion

Lung Transplantation With Donation After Circulatory Determination of Death Donors and the Impact of Ex Vivo Lung Perfusion

Donors after cardiocirculatory death and lung transplantation

Ethical Issues in the Use of Extracorporeal Membrane Oxygenation in Controlled Donation After Circulatory Determination of Death

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