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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/18716

Title: A decade of extended-criteria lung donors in a single center: was it justified?
Authors: Somers, Jana
Ruttens, David
Verleden, Stijn E.
COX, Bianca
Stanzi, Alessia
Vandermeulen, Elly
VOS, Robin
Vanaudenaerde, Bart M.
Verleden, Geert M.
Van Veer, Hans
Coosemans, Willy
Decaluwe, Herbert
Nafteux, Philippe
De Leyn, Paul
Van Raemdonck, Dirk E.
Issue Date: 2015
Citation: TRANSPLANT INTERNATIONAL, 28 (2), p. 170-179
Abstract: Despite a worldwide need to expand the lung donor pool, approximately 75% of lung offers are not accepted for transplantation. We investigated the impact of liberalizing lung donor acceptance criteria during the last decade on the number of effective transplants and early and late outcomes in our center. All 514 consecutive lung transplants (LTx) performed between Jan 2000 and Oct 2011 were included. Donors were classified as matching standard criteria (SCD; n = 159) or extended criteria (ECD; n = 272) in case they fulfilled at least one of the following criteria: age >55 years, PaO2/ FiO(2) at PEEP 5 cmH(2)O < 300 mmHg at time of offer, presence of abnormalities on chest X-ray, smoking history, presence of aspiration, presence of chest trauma, or donation after circulatory death. Outcome parameters were primary graft dysfunction (PGD) grade at 0, 12, 24, and 48 h after LTx, time to extubation, stay in intensive care unit (ICU), early and late infection, acute rejection and bronchiolitis obliterans syndrome (BOS), and survival. Two hundred and seventy-two recipients (63.1%) received ECD lungs. PGD grade at T0 was similar between groups, while at T12 (<0.01), T24 (<0.01), and T48 (<0.05), PGD3 was observed more often in ECDs. ICU stay (P < 0.05) was longer in ECDs compared with SCDs. Time to extubation, respiratory infections, acute rejection, lymphocytic bronchiolitis, BOS, and survival were not different between groups. Accepting ECDs contributed in increasing the number of lung transplants performed in our center. Although this lung donor strategy has an impact on early postoperative outcome, liberalizing criteria did not influence long-term outcome after LTx.
Notes: Prof. Dr. Dirk Van Raemdonck, Department of Thoracic Surgery, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium. +32 16 34 68 23; +32 16 34 68 24; dirk.vanraemdonck@uzleuven.be
URI: http://hdl.handle.net/1942/18716
DOI: 10.1111/tri.12470
ISI #: 000350983200007
ISSN: 0934-0874
Category: A1
Type: Journal Contribution
Validation: ecoom, 2016
Appears in Collections: Research publications

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