Use of Donors Who Died by Traumatic Asphyxiation in Lung Transplantation: A Single Center Study
| Autor: | E.C. Klipsch, Taylor J. Hathaway, R.S. Mangus |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Transplantation medicine.medical_specialty Lung business.industry medicine.medical_treatment Medical record Lung injury Single Center Surgery medicine.anatomical_structure Cohort Medicine Lung transplantation Cardiology and Cardiovascular Medicine business Cause of death |
| Zdroj: | The Journal of Heart and Lung Transplantation. 39:S381 |
| ISSN: | 1053-2498 |
| DOI: | 10.1016/j.healun.2020.01.488 |
| Popis: | Purpose Lung transplant wait list mortality remains high and poses a serious risk to those with end-stage lung disease awaiting transplantation. All available organ donors must be fully evaluated to assure that each patient receives the chance for a life-saving transplant. There is concern in the field of lung transplantation that use of donors who died by traumatic asphyxiation (TA) will have inferior post transplant outcomes. This study is designed to review the outcomes for these donors at a single center. Clinical outcomes include early and late graft function and survival, and post transplant complications. Successful use of these donors may increase the available donor pool. Methods This study is a retrospective analysis of all lung transplants at a single center over a 4-year time period (2014-2018). The original medical records as recorded by the onsite coordinator were reviewed to determine the patient cause of death and any evidence of early lung injury. Recipient hospital records were extracted to review early and late clinical outcomes and complications. Results There were 266 patients in this cohort, 15 of whom died from traumatic asphyxiation (generally by hanging as a means of suicide). In the donor, TA patients’ chest radiographs and computed tomography scans had no increased risk of an abnormal finding, except that the radiograph was more likely to show lung opacities in TA patients (57% vs 28%, p=0.02). Partial pressure of oxygen (PaO2) was equivalent for the highest level and the peak level, though TA patients did have a higher “lowest” PaO2 (100 vs 81, p=0.05). Donor bronchoscopy did not demonstrate different findings for TA donors. Clinical outcomes were equivalent post-transplant, with no differences in early graft function or 1-year survival, need for ECMO, need for tracheostomy, length of hospital stay, or hospital readmission rate. Conclusion Lung donors who die from TA appear to have equivalent clinical outcomes when compared to other lung donors. These results suggest that lung grafts from these donors can be used routinely and may provide a source of additional donor organs. |
| Databáze: | OpenAIRE |
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