Chest
Clinical InvestigationsSurgeryEffect of Donor Age and Ischemic Time on Intermediate Survival and Morbidity After Lung Transplantation
Section snippets
Materials and Methods
All adult patients undergoing lung transplantation in the UnitedStates between April 1, 1993, and March 31, 1996, recorded in the UNOSRegistry were included in this study. In the United States, 2,140 lungtransplantations were performed in adult recipients using organs fromcadaveric donors. Cohorts were reduced to have complete data sets forboth the survival and secondary end point analyses. To assess survival,a cohort of 1,800 patients was used. For analysis of secondary endpoints, the cohort
Demographics
The analyses of survival were based on the reduced cohort(n = 1,800) of adult transplant patients with complete data. Foranalysis of secondary end points, the cohort was limited to thosetransplant patients with a follow-up form submitted during either thedischarge to 1-year posttransplant period or between the 1-year and2-year posttransplant periods. This requirement reduced the cohort forthe secondary end points analyses to the 1,450 patients who underwentlung transplantation between April 1,
Discussion
Attempts at expanding the donor pool have been applied to mostsolid organs, including the lung. In thoracic transplantation,strategies to secure more potential donors have included invasivepreoperative monitoring and intervention,6 relaxation ofdonor acceptance criteria,7 revascularization of organswith significant coronary stenosis,8 lobar lungtransplantation,9 and more recently, consideration for theuse of nonbeating heart donors.10 Few studies to date haveaddressed the issue of older donor
Preoperative and Operative Variables Considered for theMultivariate Analyses
Donor Demographics
Donor sex
Donor age
Donor ischemic time
Donor tobacco use
Recipient Demographics
Recipient sex
Recipient age
Recipient Medical Factors
Recipient diagnosis
Order of transplant (primary or repeat)
In ICU before transplant
Hospitalized before transplant
Receiving life support before transplant
Receiving ventilation before transplant
Procedure type (only for FEV1 analysis)
Mismatch Variables
Sex mismatch
ABO blood group incompatibility
References (20)
- et al.
Donor lung procurement: assessment and operative technique
Ann Thorac Surg
(1993) - et al.
Influence of graft ischemic time and donor age on survival after lung transplantation
J Heart Lung Transplant
(1999) - et al.
Cardiac allografts from high-risk donors: excellent clinical results
Ann Thorac Surg
(1994) - et al.
Lobar transplantation: indications, technique, and outcome
J Thorac Cardiovasc Surg
(1994) - et al.
Non-heart beating donors: a model of thoracic allograft injury
Ann Thorac Surg
(1996) - et al.
Liberalization of donor criteria in lung and heart-lung transplantation
Ann Thorac Surg
(1994) - et al.
Successful outcome of lung transplantation is not compromised by the use of marginal donor lungs
J Thorac Cardiovasc Surg
(1995) - et al.
Short- and intermediate-term implications of using older donors for heart transplantation
Transplant Proc
(1997) - et al.
Early lung allograft function in twin recipients from the same donor: risk factor analysis
Ann Thorac Surg
(1996) - et al.
The registry of the international society for heart and lung transplantation: fourteenth official report; 1997
J Heart Lung Transplant
(1997)
Cited by (90)
The effect of allograft ischemic time on outcomes following bilateral, single, and reoperative lung transplantation
2024, Journal of Thoracic and Cardiovascular SurgeryProlonged Ischemia Increases Complications Among High- and Low-Volume Centers in Lung Transplantation
2023, Annals of Thoracic SurgeryReflux Surgery in Lung Transplantation: A Multicenter Retrospective Study
2023, Annals of Thoracic SurgeryFactors associated with short- versus long-term survival after lung transplant
2022, Journal of Thoracic and Cardiovascular SurgeryLocal versus distant lung donor procurement does not influence short-term clinical outcomes
2021, Journal of Thoracic and Cardiovascular SurgeryPredictors of nonuse of donation after circulatory death lung allografts
2021, Journal of Thoracic and Cardiovascular Surgery