Short- and Long-Term Outcome After Lung Transplantation From Circulatory-Dead Donors: A Single-Center Experience.

BACKGROUND: Donation after cardiac death (DCD) to overcome the donor organ shortage is well accepted in the clinical setting, although long-term outcome after DCD lung transplantation (LTx) remains largely unknown. METHODS: In this retrospective study, DCD LTx recipients (n=59) were compared with a cohort of donation after brain-death (DBD) LTx recipients (n=331) transplanted between February 2007 and September 2013; follow-up was until January 1st 2016. Short-term (duration of mechanical ventilation, ICU stay, hospital stay and highest PGD score within 72 hours) and long-term (CLAD-free and overall survival) follow-up were compared over a median follow-up of 50.5 (+/-3.7) months for DCD and 66.8 (+/-1.5) months for DBD. RESULTS: There were no differences between groups with regard to patient characteristics: age (p=0.78), underlying disease (p=0.30) and type of type of LTx (p=0.10), except gender where more males were transplanted with a DCD donor (62.7%) vs (48.3%, p=0.048). There was no difference in time on mechanical ventilation (p=0.59), ICU stay (p=0.74), highest PGD score (p=0.67) and hospital stay (p=0.99). Moreover, CLAD-free (p=0.86) and overall survival (p=0.15) did not differ between the DBD and DCD group. CONCLUSION: In our experience, both short- and long-term outcome in DCD lung recipients is comparable to that of DBD lung recipients. Therefore, DCD lung transplantation can be considered a safe strategy that significantly increased our transplant activity. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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