October 1, 2014
COLUMBUS, Ohio – Lung transplantation can be life-saving and improve the quality of life for some patients with end-stage lung disease. However, there is a critical shortage of suitable organs, with only 17 percent of donor lungs being successfully transplanted. According to a study published today in The Annals of Thoracic Surgery, researchers have found a way to save even more lives.
The study, led by Dr. Bryan Whitson, a cardiothoracic surgeon at The Ohio State University Wexner Medical Center, shows lungs from donors who died from asphyxiation or drowning can be safely transplanted into patients with end-stage lung disease.
“Increasing the potential donor pool would help reduce the number of patients who die waiting for a lung transplant and help expand this life-saving treatment to those who need it,” said Whitson, also head lung transplant surgeon at the Comprehensive Transplant Center at Ohio State’s Wexner Medical Center.
Using the United Network for Organ Sharing Standard Transplant Analysis and Research Database registry, Whitson and colleagues analyzed all adult lung transplant recipient data from 1987 to 2010. They focused on donor cause of death, specifically asphyxiation or drowning, and the association with recipient survival outcomes to evaluate incidence of treatment rejection within the first year post-transplant.
Researchers discovered 18,250 adult primary lung transplantations were performed during the time period, including 309 cases where donor cause of death was asphyxiation or drowning. Donor cause of death from asphyxiation or drowning was not associated with poor long-term survival or an increased incidence of treatment rejection within the first year post-transplant.
Rather, survival rates were the same for recipients of lungs from asphyxiation or drowning deaths compared to patients receiving donor lungs from all other causes of death, and there were no differences in outcomes between the two groups. In fact, recipients of lungs from donors who died from asphyxiation or drowning had fewer pulmonary deaths.
“While lung donor cause of death from asphyxiation or drowning only contributed to a modest proportion of the donor pool for this study, our results support the use of non-traditional donor lungs to potentially expand the donor pool,” Whitson said. “Asphyxiation or drowning as a donor cause of death should not automatically exclude the organ from transplant consideration.”
Individual transplant centers evaluate donors on a case-by-case basis and assess the risk, making the best match for recipients. Based on the study’s results, Whitson is hopeful that these centers could successfully expand their donor pool and increase the number of transplants by expanding their individual criteria for donation.
“Any increase in donor availability, while maintaining excellent outcomes, should be explored. It’s a matter of life or death for patients on the waiting list with end-stage lung disease,” Whitson said.