Initial lung transplantation experience with uncontrolled donation after cardiac death in North America

被引：39

作者：

Healey, Andrew ^{[1
,2
,3
]}

Watanabe, Yui ^{[4
,5
]}

Mills, Caitlin ^{[1
]}

Stoncius, Michele ^{[1
]}

Lavery, Susan ^{[1
]}

Johnson, Karen ^{[1
]}

Sanderson, Robert ^{[1
]}

Humar, Atul ^{[4
,5
]}

Yeung, Jonathan ^{[4
,5
]}

Donahoe, Laura ^{[4
,5
]}

Pierre, Andrew ^{[4
,5
]}

de Perrot, Marc ^{[4
,5
]}

Yasufuku, Kazuhiro ^{[4
,5
]}

Waddell, Thomas K. ^{[4
,5
]}

Keshavjee, Shaf ^{[4
,5
]}

Cypel, Marcelo ^{[4
,5
]}

机构：

[1] Trillium Gift Life Network, Toronto, ON, Canada

[2] McMaster Univ, Div Emergency Med, Dept Med, Hamilton, ON, Canada

[3] William Osler Hlth Syst, Div Crit Care, Dept Med, Brampton, ON, Canada

[4] Univ Toronto, Univ Hlth Network, Toronto Gen Hosp, Toronto Lung Transplant Program, Toronto, ON, Canada

[5] Univ Toronto, Univ Hlth Network, Toronto Gen Hosp, Multiorgan Transplant Program, Toronto, ON, Canada

来源：

AMERICAN JOURNAL OF TRANSPLANTATION | 2020年 / 20卷 / 06期

关键词：

clinical research; practice; translational research; science; lung transplantation; pulmonology; organ procurement and allocation; donors and donation; donation after circulatory death (DCD); extended criteria; lung (allograft) function; dysfunction; HEART-BEATING DONORS; CIRCULATORY DETERMINATION; PERFUSION;

D O I：

10.1111/ajt.15795

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Uncontrolled donation after cardiac death (uDCD) has the potential to ameliorate the shortage of suitable lungs for transplant. To date, no lung transplant data from these donors are available from North America. We describe the successful use of these donors using a simple method of in situ lung inflation so that the organ can be protected from warm ischemic injury. Forty-four potential donors were approached, and family consent was obtained in 30 cases (68%). Of these, the lung transplant team evaluated 16 uDCDs on site, and 14 were considered for transplant pending ex vivo lung perfusion assessment. Five lungs were ultimately used for transplant (16.7% use rate from consented donors). The mean warm ischemic time was 2.8 hours. No primary graft dysfunction grade 3 was observed at 24, 48, or 72 hours after transplant. Median intensive care unit stay was 5 days (range: 2-78 days), and median hospital stay was 17 days (range: 8-100 days). The 30-day mortality was 0%. Four of 5 patients are alive at a median of 651 days (range: 121-1254 days) with preserved lung function. This study demonstrates the proof of concept and the potential for uDCD lung donation using a simple donor intervention.

引用

页码：1574 / 1581

页数：8