Published ahead of print on June 23, 2006, doi:10.1164/rccm.200603-432OC Am. J. Respir. Crit. Care Med., Volume 174, Number 6, September 2006, 710-716 A more recent version of this article appeared on September 15, 2006
Submitted on March 28, 2006 Impact of a Lung Transplantation Donor-Management Protocol on Lung Donation and Recipient OutcomesLuis F Angel1*,1 Divison of Pulmonary and Critical Care Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA; Division of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA, 2 Divison of Pulmonary and Critical Care Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA; Veterans Evidence-based Research, Dissemination, and Implementation Center (VERDICT) of Excellence, Audie L. Murphy VA Hospital, San Antonio, Texas, USA, 3 Division of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA, 4 Veterans Evidence-based Research, Dissemination, and Implementation Center (VERDICT) of Excellence, Audie L. Murphy VA Hospital, San Antonio, Texas, USA, 5 Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA, 6 Texas Organ Sharing Alliance, San Antonio, Texas, USA, 7 Divison of Pulmonary and Critical Care Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA * To whom correspondence should be addressed. E-mail: angel{at}uthscsa.edu.
Rationale: One of the limitations associated with lung transplantation is the lack of available organs. Objective: To determine whether a lung donor-management protocol could increase the number of lungs for transplantation without affecting the survival rates of recipients. Methods: We implemented the San Antonio Lung Transplant protocol for managing potential lung donors according to modifications of standard criteria for donor selection and strategies for donor management. We then compared information gathered during a four-year period during which the protocol was used with information gathered during a four-year period before protocol implementation. Primary outcome measures were the procurement rate of lungs and the 30-day and 1-year survival rates of recipients. Main Results: We reviewed data from 711 potential lung donors. The mean rate of lung procurement was significantly higher (P<.0001) during the protocol period (25.5%) than during the preprotocol period (11.5%), with an estimated risk ratio of 2.2 in favor of the protocol period. More lungs were transplanted during the protocol period (121) than during the preprotocol period (53;P<.0001). Of 98 actual lung donors during the protocol period, 53 (54%) had initially been considered poor donors; these donors provided 64 (53%) of the 121 lung transplants. The type of donor was not associated with significant differences in recipients' 30-day and 1-year survival rates or any clinical measures of adequate graft function. Conclusions: The protocol was associated with a significant increase in the number of lung donors and transplant procedures without compromising pulmonary function, length of stay, or survival of the recipients. Key words: Lung transplantation, organ donor, organ donation, lung recipients, survival
This article has been cited by other articles:
|
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
