Lung donor treatment protocol in brain dead-donors: A multicenter study

J Heart Lung Transplant. 2015 Jun;34(6):773-80. doi: 10.1016/j.healun.2014.09.024. Epub 2014 Sep 28.


Background: The shortage of lung donors for transplantation is the main limitation among patients awaiting this type of surgery. We previously demonstrated that an intensive lung donor-treatment protocol succeeded in increasing the lung procurement rate. We aimed to validate our protocol for centers with or without lung transplant programs.

Methods: A quasi-experimental study was performed to compare lung donor rate before (historical group, 2010 to 2012) and after (prospective group, 2013) the application of a lung management protocol for donors after brain death (DBDs) in six Spanish hospitals. Lung donor selection criteria remained unchanged in both periods. Outcome measures for lung recipients were early survival and primary graft dysfunction (PGD) rates.

Results: A total of 618 DBDs were included: 453 in the control period and 165 in the protocol period. Donor baseline characteristics were similar in both periods. Lung donation rate in the prospective group was 27.3%, more than twice that of the historical group (13%; p < 0.001). The number of lungs retrieved, grafts transplanted, and transplants performed more than doubled over the study period. No differences in early recipients' survival between groups were observed (87.6% vs. 84.5%; p = 0.733) nor in the rate of PGD.

Conclusion: Implementing our intensive lung donor-treatment protocol increases lung procurement rates. This allows more lung transplants to be performed without detriment to either early survival or PGD rate.

Keywords: brain-dead donor; donor treatment; lung donor; multicenter study; outcome; primary graft dysfunction; protocol.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Brain Death*
  • Female
  • Graft Rejection / epidemiology
  • Humans
  • Incidence
  • Lung Transplantation / mortality
  • Lung Transplantation / statistics & numerical data*
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Patient Selection*
  • Prospective Studies
  • Retrospective Studies
  • Spain / epidemiology
  • Survival Rate
  • Tissue Donors / statistics & numerical data*
  • Tissue and Organ Procurement / methods*
  • Transplant Recipients / statistics & numerical data*