OUTCOME IN PAIRED RECIPIENTS OF SINGLE-LUNG TRANSPLANTS FROM THE SAMEDONOR

Background and Methods: We compared outcome measures in twenty single lung transplant recipients: 10 patients received the first lung of a d onor pair (group 1), and 10 patients received the second lung (group 2 ) to determine the feasibility of sequential use, respectively, of don or lungs from the same donor in the same institution. The paired recip ients underwent transplantation in the same operating room by the same surgical team. Both groups were well matched for age, gender, pretran splantation symptom class and diagnosis. Results: The ischemic time fo r group 1 versus group 2 was 164 +/- 53 minutes (mean +/- standard dev iation) (range 103 to 250 minutes) versus 377 +/- 53 minutes (range 31 5 to 455 minutes), respectively, (p < 0.001), but the longer ischemic time for group 2 did not adversely affect time to extubation (10.6 +/- 5.1 hours versus 10.3 +/- 7.6 hours; p = Not significant), early gas exchange (partial pressure of arterial oxygen on a fractional concentr ation of oxygen in inspired gas of 0.60: 237 +/- 61 versus 267 +/- 88 mm Pig; p = Not significant), length of hospital stay (16 +/- 13 days versus 16 +/- 5 days; p = Not significant), or actuarial one-year surv ival (80 +/- 12% versus 90 +/- 12%; p = Not significant). However, acu te lung rejection (expressed as events/100 days) was more common withi n the first 3 months in group 1 versus group 2 (2.68 +/- 0.57 versus 1 .32 +/- 0.38, respectively; p < 0.01), as were infectious events (2.07 +/- 0.50 versus 0.99 +/- 0.33; p < 0.01). Conclusions: These data con firm the safety of using the second lung from a donor pair sequentiall y in the same institution. The longer cold ischemic time for the secon d lung does not impair demonstrably early graft function and may be as sociated with a lower perioperative morbidity from acute rejection and subsequent infection. One-year outcome appears favorable for both gro ups.