Uncontrolled DCD lungs can survive the donor’s death for an afterlife dimension in another body

Raemdonck, Dirk Van; Ceulemans, Laurens J.; Neyrinck, Arne

doi:10.1111/ajt.15868

Cited by 2 publications

(2 citation statements)

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“…Although there were 147 sudden death victims over 39 months with substantial logistical issues, these additional lung donors all came from one suburban hospital, in a metropolitan area of 6 million people (62). This underscores the potential number of lungs from uDCDs, highlighted in the accompanying editorial (75). The Milan lung transplant group reported another successful lung transplant from an uDCD donor, performed after 17 hours of EVLP, necessary to rule out leukemia in the donor (76).…”

Section: Results Of Lung Transplant From Udcdsmentioning

confidence: 99%

Donation after circulatory death donors in lung transplantation

Egan¹,

Haithcock²,

Lobo³

et al. 2021

J Thorac Dis

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Transplantation of any organ into a recipient requires a donor. Lung transplant has a long history of an inadequate number of suitable donors to meet demand, leading to deaths on the waiting list annually since national data was collected, and strict listing criteria. Before the Uniform Determination of Death Act (UDDA), passed in 1980, legally defined brain death in the U.S., all donors for lung transplant came from sudden death victims [uncontrolled Donation after Circulatory Death donors (uDCDs)] in the recipient's hospital emergency department. After passage of the UDDA, uDCDs were abandoned to Donation after Brain Death donors (DBDs)-perhaps prematurely. Compared to livers and kidneys, many DBDs have lungs that are unsuitable for transplant, due to aspiration pneumonia, neurogenic pulmonary edema, trauma, and the effects of brain death on lung function. Another group of donors has become available-patients with a devastating irrecoverable brain injury that do not meet criteria for brain death. If a decision is made by next-of-kin (NOK) to withdraw life support and allow death to occur by asphyxiation, with NOK consent, these individuals can have organs recovered if death occurs relatively quickly after cessation of mechanical ventilation and maintenance of their airway. These are known as controlled Donation after Circulatory Death donors (cDCDs). For a variety of reasons, in the U.S., lungs are recovered from cDCDs at a much lower rate than kidneys and livers. Ex-vivo lung perfusion (EVLP) in the last decade has had a modest impact on increasing the number of lungs for transplant from DBDs, but may have had a larger impact on lungs from cDCDs, and may be indispensable for safe transplantation of lungs from uDCDs. In the next decade, DCDs may have a substantial impact on the number of lung transplants performed in the U.S. and around the world.

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Section: Results Of Lung Transplant From Udcdsmentioning

confidence: 99%

Donation after circulatory death donors in lung transplantation

Egan¹,

Haithcock²,

Lobo³

et al. 2021

J Thorac Dis

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mentioning

confidence: 99%

Afterlife for lungs: A way to increase donor lungs for transplant

Egan

Requard²

2020

American Journal of Transplantation

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We write to congratulate the group from Toronto for successfully transplanting 5 patients with lungs recovered from uncontrolled donation after circulatory death (uDCD) donors 1 and to comment on the thoughtful accompanying editorial by Van Raemdonck and his colleagues. 2 The Toronto group used ex vivo lung perfusion (EVLP) to assess lungs recovered from 14 uDCDs and performed 5 lung transplants with excellent outcomes. Over 39 months, 147 sudden death victims without obvious contraindications were offered for consideration from 1 suburban hospital. Next-of-kin (NOK) from 44 uDCDs were approached, and consent was obtained from 30. These numbers are similar to our experience. 3 Of 502 sudden death victims, there were 287 medical ruleouts and 224 others with various reasons for nonrecovery, including NOK issues in 115. Although 2 lungs were determined to be suitable, none were transplanted.

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Uncontrolled DCD lungs can survive the donor’s death for an afterlife dimension in another body

Abstract: The Toronto Lung Transplant Group reported safe transplantation of DCD lungs when preceded with prior ex situ perfusion of pulmonary allografts for functional testing. See Healey et al's article on page 1574.

Cited by 2 publications

References 4 publications

Donation after circulatory death donors in lung transplantation

Donation after circulatory death donors in lung transplantation

Afterlife for lungs: A way to increase donor lungs for transplant

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