Impact of a lung transplantation donor-management protocol on lung donation and recipient outcomes

Luis F. Angel, Deborah J. Levine, Marcos I. Restrepo, Scott Johnson, Edward Sako, Andrea Carpenter, John Calhoon, John E. Cornell, Sandra G. Adams, Gary B. Chisholm, Joe Nespral, Ann Roberson, Stephanie M. Levine

Research output: Contribution to journalReview article

118 Scopus citations

Abstract

Rationale: One of the limitations associated with lung transplantation is the lack of available organs. Objective: To determine whether a lung donor-management protocol could increase the number of lungs for transplantation without affecting the survival rates of the recipients. Methods: We implemented the San Antonio Lung Transplant protocol for managing potential lung donors according to modifications of standard criteria for donor selection and strategies for donor management. We then compared information gathered during a 4-yr period, during which the protocol was used with information gathered during a 4-yr period before protocol implementation. Primary outcome measures were the procurement rate of lungs and the 30-d and 1-yr survival rates of recipients. Main Results: We reviewed data from 711 potential lung donors. The mean rate of lung procurement was significantly higher (p < 0.0001) during the protocol period (25.5%) than during the preprotocol period (11.5%), with an estimated risk ratio of 2.2 in favor of the protocol period. More patients received transplants during the protocol period (n = 121) than during the pre-protocol period (n = 53; p < 0.0001). Of 98 actual lung donors during the protocol period, 53 (54%) had initially been considered poor donors; these donors provided 64 (53%) of the 121 lung transplants. The type of donor was not associated with significant differences in recipients' 30-d and 1-yr survival rates or any clinical measures of adequate graft function. Conclusions: The protocol was associated with a significant increase in the number of lung donors and transplant procedures without compromising pulmonary function, length of stay, or survival of the recipients.

Original languageEnglish (US)
Pages (from-to)710-716
Number of pages7
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume174
Issue number6
DOIs
Publication statusPublished - Sep 21 2006

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Keywords

  • Lung recipients
  • Lung transplantation
  • Organ donation
  • Organ donor
  • Survival

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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