Feasibility of lung transplantation from donors mechanically ventilated for prolonged periods

• Published in: Surgery today (Tokyo, Japan) Vol. 49; no. 3; pp. 254 - 260
• Main Authors: Sugimoto, Seiichiro, Kurosaki, Takeshi, Otani, Shinji, Tanaka, Shin, Hikasa, Yukiko, Yamane, Masaomi, Toyooka, Shinichi, Kobayashi, Motomu, Oto, Takahiro
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.03.2019
• Subjects: Adult; Feasibility Studies; Female; Humans; Lung Transplantation - mortality; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Respiration, Artificial - adverse effects; Retrospective Studies; Surgery; Surgical Oncology; Survival Rate; Time Factors; Tissue and Organ Procurement; Tissue Donors; Treatment Outcome; Brain-dead donor; Extended-criteria donor; Marginal donor; Mechanical ventilation; Lung transplantation
• ISSN: 0941-1291; 1436-2813; 1436-2813
• DOI: 10.1007/s00595-018-1730-z

Purpose When patients are mechanically ventilated for more than 5 days, they are usually declined as donors for lung transplantation (LTx); thus, the long-term outcomes of LTx from such donors remain unclear. We investigated the feasibility of LTx from donors that had been mechanically ventilated for prolonged periods. Methods The subjects of this retrospective comparative investigation were 31 recipients of LTx from donors who had been mechanically ventilated for < 5 days (short-term group) and 50 recipients of LTx from donors who had been mechanically ventilated for ≥ 5 days (long-term group). Results The median duration of donor mechanical ventilation was 3 days in the short-term group and 8.5 days in the long-term group. However, other than the difference in the duration of donor ventilation, there were no significant differences in the clinical characteristics of the donors or recipients between the groups. The overall survival rate after LTx was comparable between the long-term group and short-term group (5-year survival rate, 66.6% vs. 75.2%). Conclusion The potential inclusion of donors who have been on mechanical ventilation for more than 5 days could be a feasible strategy to alleviate donor organ shortage.