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Strategies to increase limited donor resources

¹ Toronto Lung Transplant Programme, Toronto General Hospital, Toronto, Canada. ² Division of Thoracic Surgery, University Hospital, Zurich, Switzerland. ³ Division of Cardiothoracic Surgery, Washington University School of Medicine, St Louis, MO, USA

CORRESPONDENCE: S. Keshavjee, Toronto General Hospital, 200 Elizabeth Street, EN 10-224, Toronto, ON M5G 2C4, Canada. Fax: 1 4163404556. E-mail: shaf.keshavjee@uhn.on.ca

Keywords: donor, graft failure, lung, preservation, reperfusion injury, transplantation

Received: August 17, 2003
Accepted August 20, 2003

Abstract

A number of strategies have been advocated to increase the number of lung donors including: 1) improvement in donor resuscitation; 2) better methods of lung preservation; 3) extension of the lung donor selection criteria; 4) development of a living-related lung donor programme; and 5) utilisation of nonheart beating donors.

Other strategies such as the split-lung technique and techniques of lung reduction to accommodate large lungs into a small-size recipient have also been used successfully. In this article, each of these strategies have been reviewed and some recommendations are suggested based on the authors' own experience and that of the literature.

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