Open AccessImpact of donor lung quality on post‐transplant recipient outcome in the Lung Allocation Score era in Eurotransplant – a historical prospective study
Author(s) -
Smits Jacqueline M.,
Gottlieb Jens,
Verschuuren Erik,
Evrard Patrick,
Hoek Rogier,
Knoop Christiane,
Lang György,
Kwakkelvan Erp Johanna M.,
Vos Robin,
Verleden Geert,
Rondelet Benoit,
Hoefer Daniel,
Langer Frank,
Schramm Rene,
Hoetzenecker Konrad,
Kessel Diana,
Luijk Bart,
Seghers Leonard,
Deuse Tobias,
Buhl Roland,
Witt Christian,
Strelniece Agita,
Green Dave,
Vries Erwin,
Laufer Guenter,
Van Raemdonck Dirk
Publication year - 2020
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.13582
Subject(s) - medicine , donation , lung transplantation , lung , surgery , economics , economic growth
Summary The aim of this study was to investigate whether there is an impact of donation rates on the quality of lungs used for transplantation and whether donor lung quality affects post‐transplant outcome in the current Lung Allocation Score era. All consecutive adult LTx performed in Eurotransplant (ET) between January 2012 and December 2016 were included ( N = 3053). Donors used for LTx in countries with high donation rate were younger (42% vs. 33% ≤45 years, P < 0.0001), were less often smokers (35% vs. 46%, P < 0.0001), had more often clear chest X‐rays (82% vs. 72%, P < 0.0001), had better donor oxygenation ratios (20% vs. 26% with PaO 2 /FiO 2 ≤ 300 mmHg, P < 0.0001), and had better lung donor score values (LDS; 28% vs. 17% with LDS = 6, P < 0.0001) compared with donors used for LTx in countries with low donation rate. Survival rates for the groups LDS = 6 and ≥7 at 5 years were 69.7% and 60.9% ( P = 0.007). Lung donor quality significantly impacts on long‐term patient survival. Countries with a low donation rate are more oriented to using donor lungs with a lesser quality compared to countries with a high donation rate. Instead of further stretching donor eligibility criteria, the full potential of the donor pool should be realized.