Thoracic organ donor characteristics associated with successful lung procurement

Purpose: A shortage of suitable donors is the major impediment to clinical lung transplantation. The rate of lung recovery from potential donors is lo wer than that for other organs. The purpose of this study was to evaluate w hat factors could be modified to improve the rate of cadaver lung recovery. Methods. We performed a retrospective review of records from all thoracic o rgan donors procured by the California Transplant Donor Network between 1 J anuary 1995 and 31 May 1997 (251 donors) to determine which donor managemen t factors were associated with an increased likelihood of successful lung p rocurement. Results: There were 88 lung donors (L) and 163 donors from which hearts but no lungs were procured (H). Longer time to donor network referral was asso ciated with a reduced chance for successful lung procurement. Donor age, ca use of death, and time of admission were not important factors. Most donors in this study had an acceptable A-a gradient at admission to the hospital but lung function deteriorated in group H. Corticosteroid usage and initial ly clear breath sounds were independent predictors of successful procuremen t by multivariate analysis. Conclusions: Early contact with the donor referral network, and corticoster oids may help to improve the lung procurement rate from potential donors.