TITLE

Extended donor lungs: eleven years experience in a consecutive series

AUTHOR(S)
Lardinois, Didier; Banysch, Marc; Korom, Stephan; Hillinger, Sven; Rousson, Valentin; Boehler, Annette; Speich, Rudolf; Weder, Walter
PUB. DATE
May 2005
SOURCE
European Journal of Cardio-Thoracic Surgery;May2005, Vol. 27 Issue 5, p762
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Abstract: Objective: The aim of this study was to delineate the profile of extended donor lungs in comparison to ideal donor lungs and to analyse their outcome. Particular attention was given to donor lungs with a low PaO2 (<250mmHg) before harvesting or with multiple extended criteria. Methods: Between 1993 and 2003, 148 patients (79 women, 69 men, mean age 39.9 years) underwent lung transplantation. Indications were cystic fibrosis in 35.8%, emphysema in 26.4%, pulmonary fibrosis in 12.2%, pulmonary hypertension in 9.5%, and others in 16.1%. Donor data and recipients medical files were reviewed. Criteria for donor lungs were considered extended if one or more of the following criteria were met: age >55 years, smoking >20 pack-years, PaO2 before harvesting <300mmHg, pathologic chest X-ray, and purulent secretion at bronchoscopy. A comparison between recipients from ideal and from extended donor lungs was performed with respect to the median duration of mechanical ventilation, the median length of stay at the intensive care unit, postoperative complications, the 30-day and the 1-year survival, and the 6-month follow-up spirometry. Results: Sixty-three (42.6%) donor lungs were considered extended and 20 (31.7%) met more than one criteria. Outcome comparison between recipients from ideal (I) and extended (II) donor lungs did not statistically differ in postoperative complications (18.8% (I) vs. 26.9% (II), P=0.32), mean duration of mechanical ventilation (d) (4.4±2.7 (I) vs. 2.6±2.1 (II), P=0.2), mean length of stay at the ICU (d) (11.5±8.8 (I) vs. 9.2±6.9 (II), P=0.4), 6-month pulmonary function (FEV1=83±23% of the predicted value (I) vs. 82±18% (II), P=0.81), 30-day survival (90.6% (I) vs. 93.7% (II), P=0.56), 1-year survival (83.5% (I) vs. 81% (II), P=0.83). Thirty-day survival was also comparable even in recipients from donor lungs with PaO2<250mmHg (n=8) (90.6% (I) vs. 87.5%, P=0.57). The number of extended criteria had no impact on the outcome. The combination of PaO2<300mmHg with purulent secretion at bronchoscopy seemed to influence the early outcome of recipients from extended donor lungs negatively. Conclusions: Our results suggest that the use of selected extended donor lungs does not compromise the outcome after transplantation. PaO2 <250mmHg before harvesting of the lungs is not an absolute contra-indication for transplantation.
ACCESSION #
17674389

 

Related Articles

  • Pulmonary acceleration time to optimize the timing of lung transplant in cystic fibrosis. Damy, Thibaud; Burgel, Pierre-R�gis; Pepin, Jean-Louis; Boelle, Pierre-Yves; Cracowski, Claire; Murris-Espin, Marl�ne; Nove-Josserand, Raphaele; Stremler, Nathalie; Simon, Tabassome; Adnot, Serge; Fauroux, Brigitte // Pulmonary Circulation;2012, Vol. 2 Issue 1, p75 

    Pulmonary hypertension (PH) may affect survival in cystic fibrosis (CF) and can be assessed on echocardiographic measurement of the pulmonary acceleration time (PAT). The study aimed at evaluating PAT as a tool to optimize timing of lung transplant in CF patients. Prospective multicenter...

  • Is CFTR-delF508 Really Absent from the Apical Membrane of the Airway Epithelium? Borthwick, Lee A.; Botha, Phil; Verdon, Bernard; Brodlie, Malcolm J.; Gardner, Aaron; Bourn, David; Johnson, Gail E.; Gray, Mike A.; Fisher, Andrew J. // PLoS ONE;2011, Vol. 6 Issue 8, p1 

    Background: Understanding where mutant CFTR is localised in airway epithelia is essential in guiding the best therapeutic approach to correct the dysfunction of the CFTR protein. The widely held paradigm is that CF patients harbouring the commonest mutation, CFTR-delF508, trap CFTR within the...

  • Lung Transplantation: An Overview of Candidacy and Outcomes. Rampolla, Reinaldo // Ochsner Journal;Winter2014, Vol. 14 Issue 4, p641 

    Background: Various factors must be taken into account when considering lung transplantation, including candidacy, contra- indications, and outcomes. Methods: This article presents a review of the data and literature on lung transplantation, tracking the evolution of the treatment as it applies...

  • Lung Transplantation: a Treatment Option in End-Stage Lung Disease. Hartert, Marc; Senbaklavaci, Ömer; Gohrbandt, Bernhard; Fischer, Berthold M.; Buhl, Roland; Vahl, Christian-Friedrich // Deutsches Aerzteblatt International;2/14/2014, Vol. 111 Issue 7, p107 

    Background: Lung transplantation is the final treatment option in the end stage of certain lung diseases, once all possible conservative treatments have been exhausted. Depending on the indication for which lung transplantation is performed, it can improve the patient's quality of life (e.g., in...

  • 'Spare the Cough, Spoil the Airway:' Back to the Basics in Airway Clearance.  // Pediatric Nursing;Mar/Apr2002, Vol. 28 Issue 2, p107 

    Examines coughing as an essential mechanism for airway clearance. Information on cystic fibrosis; Discussion on airway physiology; Four primary airway clearance technique methods; Conclusion.

  • The Effect of Pleural Adhesions on Pediatric Cystic Fibrosis Patients Undergoing Lung Transplantation. Bremner, Ross M.; Woo, Marilyn S.; Arroyo, Hector; Nigro, John J.; Horn, Monica V.; Wells, Winfield J.; Barr, Mark; Starnes, Vaughn A. // American Surgeon;Dec2001, Vol. 67 Issue 12, p1136 

    The degree of pleural scarring complicating cystic fibrosis (CF) lung disease is thought to impact on the outcome of adult lung transplantation. This has not been previously studied in the pediatric population. We studied all patients undergoing lung transplantation at Children's Hospital Los...

  • Emergency lung transplantation contributes to knock down mortality on the waiting list. Anile, Marco; Diso, Daniele; Frati, Giacomo; Venuta, Federico // European Journal of Cardio-Thoracic Surgery;May2012, Vol. 41 Issue 5, p1220 

    A letter to the editor is presented in response to the article "Urgent lung transplantation in cystic fibrosis patients: experience of a French center" by M. G. Saueressig and colleagues in the 2011 issue.

  • Maxillary sinus surgery in maxillary sinusitis with cystic fibrosis. Erkan, Alper // European Archives of Oto-Rhino-Laryngology;Jun2013, Vol. 270 Issue 6, p1969 

    A letter to the editor is presented in response to the article "Posttransplant sinus surgery in lung transplant recipients with cystic fibrosis: a single institutional experience," by D. Vital and colleagues in the 2013 issue.

  • Lung transplant and cystic fibrosis: what's new from the UK and France? Noone, Peadar G. // Thorax;Aug2008, Vol. 63 Issue 8, p668 

    The article discusses a study which suggests that lung transplant for most children with cystic fibrosis under 18 years of age offers no survival advantage. The complex statistical methodology and conclusions have since been challenged and rebutted by several lung transplant experts. It...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics