Expanding the donor lung pool: how many donations after circulatory death organs are we missing?

William Zachary Chancellor, Eric J. Charles, James Hunter Mehaffey, Robert B. Hawkins, Carrie A. Foster, Ashish K. Sharma, Victor E. Laubach, Irving L. Kron, Curtis G. Tribble

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background The number of patients with end-stage pulmonary disease awaiting lung transplantation is at an all-time high, while the supply of available organs remains stagnant. Utilizing donation after circulatory death (DCD) donors may help to address the supply-demand mismatch. The objective of this study is to determine the potential donor pool expansion with increased procurement of DCD organs from patients who die at hospitals. Material and methods The charts of all patients who died at a single, rural, quaternary-care institution between August 2014 and June 2015 were reviewed for lung transplant candidacy. Inclusion criteria were age <65 y, absence of cancer and lung pathology, and cause of death other than respiratory or sepsis. Results A total of 857 patients died within a 1-year period and were stratified by age: pediatric <15 y (n = 32, 4%), young 15-64 y (n = 328, 38%), and old >65 y (n = 497, 58%). Those without cancer totaled 778 (90.8%) and 512 (59%) did not have lung pathology. This leaves 85 patients qualifying for DCD lung donation (pediatric n = 10, young n = 75, and old n = 0). Potential donors were significantly more likely to have clear chest X-rays (24.3% versus 10.0%, P < 0.0001) and higher mean PaO2/FiO2 (342.1 versus 197.9, P < 0.0001) compared with ineligible patients. Conclusions A significant number of DCD lungs are available every year from patients who die within hospitals. We estimate the use of suitable DCD lungs could potentially result in a significant increase in the number of lungs available for transplantation.

Original languageEnglish (US)
Pages (from-to)58-63
Number of pages6
JournalJournal of Surgical Research
Volume223
DOIs
StatePublished - Mar 2018
Externally publishedYes

Keywords

  • Donation after circulatory death
  • Donor pool size
  • High-risk donation
  • Lung transplantation

ASJC Scopus subject areas

  • Surgery

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    Chancellor, W. Z., Charles, E. J., Mehaffey, J. H., Hawkins, R. B., Foster, C. A., Sharma, A. K., Laubach, V. E., Kron, I. L., & Tribble, C. G. (2018). Expanding the donor lung pool: how many donations after circulatory death organs are we missing? Journal of Surgical Research, 223, 58-63. https://doi.org/10.1016/j.jss.2017.09.029