Ischemia-reperfusion injuryLung Procurement for Transplantation: New Criteria for Lung Donor Selection
Section snippets
Materials and Methods
Via a collaborative study with the NITp, the regional center for organ and tissue validation and allocation, we presented new selective criteria for LD, which were adopted by the transplant coordinator A.O. Niguarda Cà Granda. Brain death diagnosed in the neurological intensive care unit allowed organs donors to be identified for transplantation.
The criteria to exclude lung retrieval were limited to: general exclusion donor criteria,6 documented lung inhalation, PaO2/FiO2 < 250 (FiO2 1.0), and
Results
Among 31 cerebral deaths in 2008, we selected seven LD. Cerebral death was caused by vascular disease (n = 4) posttraumatic lesions (n = 2), or secondary to a postanoxic cerebral damage (n = 1; Table 1). The procured lungs were all transplanted; primary organ function was achieved in five recipients, nonfunction due to reperfusion damage, as reported by the surgeons in two cases.
Donor age was distributed over a wide range: over the age of 50 years (n = 3) or over 55 years old (n = 2) (Table 2).
Discussion
New exclusion criteria adopted for LD selection were reduced to a minimum, albeit in agreement with safety considerations. This strategy was adopted to meet the organ shortage that is particularly severe for LD. We sought to apply these criteria to collect a donor pool as largest as possible. The criteria we used for LD were effective to increase lung procurement to a positive trend in 2008 compared with 2007. All selected lungs were used for transplantation. Primary organ function, although a
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