Short- and long-term outcomes of using pulmonary allograft donors with low Po-2

Luckraz, Heyman, White, Paul, Sharples, Linda D., Hopkins, Peter and Wallwork, John (2005) Short- and long-term outcomes of using pulmonary allograft donors with low Po-2. Journal of Heart and Lung Transplantation, 24 4: 470-473. doi:10.1016/j.healun.2004.02.012

Author Luckraz, Heyman
White, Paul
Sharples, Linda D.
Hopkins, Peter
Wallwork, John
Title Short- and long-term outcomes of using pulmonary allograft donors with low Po-2
Formatted title
Short- and long-term outcomes of using pulmonary allograft donors with low PO2
Journal name Journal of Heart and Lung Transplantation   Check publisher's open access policy
ISSN 1053-2498
Publication date 2005-04
Sub-type Article (original research)
DOI 10.1016/j.healun.2004.02.012
Volume 24
Issue 4
Start page 470
End page 473
Total pages 4
Place of publication Philadelphia, PA, United States
Publisher Elsevier
Language eng
Formatted abstract
Background: The establishment of lung transplantation as a treatment modality for end-stage lung disease has led to an imbalance in the demand and supply for such a procedure. Increasingly marginal donors are being accepted for transplantation. We assessed the short- and long-term outcomes with the use of lung donors with low Po2.
Methods: All heart-lung and double lung transplantations (n = 362) carried out between 1984 and 2001 were included. Recipients were divided according to the optimized donor Po2 (on 100% Fio2): Po2 = 30 to 40 kPa = low Po2 donors (n = 50) and Po2 >40 kPa = normal Po2 donors (n = 312). There were no differences in the sex distribution, cytomegalovirus infection status, ischemic time, and intubation durations for the recipients and their respective donors between the 2 groups. The low Po2 donors were older (38 vs 32 years, p = 0.01) and the allografts were transplanted into younger recipients (33 vs 38 years, p = 0.01).
Results: There was a trend toward an increase in the 30-day mortality between the 2 groups (22% vs 13%, odds ratio 1.92, 95% confidence interval 0.91–4.05 p = 0.08). The 1- and 5-year survival rates (standard error) were 66% (7%) and 52% (7%) for the low Po2 group and 72% (3%) and 44% (3%) for the normal Po2 group (p = 0.97). Similar infection rates were recorded for the groups. Although rejection rates were similar in the first 3 months, there was a lower rate of rejection in the low Po2 group thereafter, (hazard ratio, 0.52; p = 0.05). Risk of bronchiolitis obliterans syndrome (BOS) onset was marginally increased in the borderline donors (hazard ratio 1.05, 95% confidence interval 0.68–1.62), although this was not statistically significant.
Conclusions: Donor lung allograft, with optimized Po2 between 30 and 40 kPa on 100% Fio2, used for lung transplantation did compromise 30-day mortality, but the difference in mortality did not extend beyond 30 days in our patient group.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
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