Skip to main content
Log in

Procurement of lungs from brain-dead donors

  • Review Article
  • Published:
Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Lung transplantation is the procedure of choice in many patients with end-stage lung disease and is being performed more frequently around the world. However, there continues to be shortage of donor organs with the ever-expanding number of recipients on the waiting list, leading to liberalization of the lung donor selection criteria with increasing acceptance of marginal donors while striving for excellent results. This has placed an increasing emphasis on the technique of donor lung procurement and preservation from marginal donors. Good judgment and procurement techniques are necessary to obtain high-quality donor lungs for transplantation and optimize long-term results. This is a review of our current technique used for the procurement of the lungs from brain-dead donors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. United network for organ sharing. Transplant Trends. https://unos.org/data/transplant-trends/

  2. Chambers DC, Cherikh WS, Harhay MO, et al. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-sixth adult lung and heart-lung transplantation Report-2019; Focus theme: Donor and recipient size match. J Heart Lung Transplant. 2019;38:1042–55.

    Article  Google Scholar 

  3. Courtwright A, Cantu E. Evaluation and management of the potential lung donor. Clin Chest Med. 2017;38:751–9.

    Article  Google Scholar 

  4. Bittle GJ, Sanchez PG, Kon ZN, et al. The use of lung donors older than 55 years: a review of the United Network of Organ Sharing database. J Heart Lung Transplant. 2013;32:760–8.

    Article  Google Scholar 

  5. Bonser RS, Taylor R, Collett D, Thomas HL, Dark JH, Neuberger J. Effect of donor smoking on survival after lung transplantation: a cohort study of a prospective registry. Lancet. 2012;380:747–55.

    Article  Google Scholar 

  6. Taghavi S, Jayarajan SN, Komaroff E, et al. Single-lung transplantation can be performed with acceptable outcomes using selected donors with heavy smoking history. J Heart Lung Transplant. 2013;32:1005–12.

    Article  Google Scholar 

  7. Hayes D Jr, Black SM, Tobias JD, Higgins RS, Whitson BA. Influence of donor and recipient age in lung transplantation. J Heart Lung Transplant. 2015;34:43–9.

    Article  Google Scholar 

  8. Aigner C, Winkler G, Jaksch P, et al. Extended donor criteria for lung transplantation—a clinical reality. Eur J Cardiothorac Surg. 2005;27:757–61.

    Article  Google Scholar 

  9. Divithotawela C, Cypel M, Martinu T, et al. Long-term outcomes of lung transplant with ex vivo lung perfusion. JAMA Surg. 2019;154:1143–50.

    Article  Google Scholar 

  10. Chan PG, Kumar A, Subramaniam K, Sanchez PG, editors. Ex vivo lung perfusion: a review of research and clinical practices. seminars in cardiothoracic and vascular anesthesia. Los Angeles: SAGE Publications Sage; 2020.

    Google Scholar 

  11. Fujimura S, Handa M, Kondo T, Ichinose T, Shiraishi Y, Nakada T. Successful 48-hour simple hypothermic preservation of canine lung transplants. Transplant Proc. 1987;19:1334–6.

    PubMed  CAS  Google Scholar 

  12. Keshavjee SH, Yamazaki F, Cardoso PF, McRitchie DI, Patterson GA, Cooper JD. A method for safe twelve-hour pulmonary preservation. J Thorac Cardiovasc Surg. 1989;98:529–34.

    Article  CAS  Google Scholar 

  13. Date H, Matsumura A, Manchester JK, et al. Evaluation of lung metabolism during successful twenty-four-hour canine lung preservation. J Thorac Cardiovasc Surg. 1993;105:480–91.

    Article  CAS  Google Scholar 

  14. Arnaoutakis GJ, Allen JG, Merlo CA, Baumgartner WA, Conte JV, Shah AS. Low potassium dextran is superior to University of Wisconsin solution in high-risk lung transplant recipients. J Heart Lung Transplant. 2010;29:1380–7.

    Article  Google Scholar 

  15. Fischer S, Matte-Martyn A, De Perrot M, et al. Low-potassium dextran preservation solution improves lung function after human lung transplantation. J Thorac Cardiovasc Surg. 2001;121:594–6.

    Article  CAS  Google Scholar 

  16. Müller C, Fürst H, Reichenspurner H, Briegel J, Groh J, Reichart B. Lung procurement by low-potassium dextran and the effect on preservation injury. Transplantation. 1999;68:1139–43.

    Article  Google Scholar 

  17. Oto T, Griffiths AP, Rosenfeldt F, Levvey BJ, Williams TJ, Snell GI. Early outcomes comparing Perfadex, Euro-Collins, and Papworth solutions in lung transplantation. Ann Thorac Surg. 2006;82:1842–8.

    Article  Google Scholar 

  18. Rabanal JM, Ibañez AM, Mons R, et al. Influence of preservation solution on early lung function (Euro-Collins vs Perfadex). Transplant Proc. 2003;35:1938–9.

    Article  CAS  Google Scholar 

  19. Strüber M, Wilhelmi M, Harringer W, et al. Flush perfusion with low potassium dextran solution improves early graft function in clinical lung transplantation. Eur J Cardiothorac Surg. 2001;19:190–4.

    Article  Google Scholar 

  20. Thabut G, Vinatier I, Brugière O, et al. Influence of preservation solution on early graft failure in clinical lung transplantation. Am J Respir Crit Care Med. 2001;164:1204–8.

    Article  CAS  Google Scholar 

  21. Hopkinson DN, Bhabra MS, Hooper TL. Pulmonary graft preservation a worldwide survey of current clinical practice. J Heart Lung Transplant. 1998;17:525–31.

    PubMed  CAS  Google Scholar 

  22. de Perrot M, Fischer S, Liu M, et al. Prostaglandin E1 protects lung transplants from ischemia-reperfusion injury: a shift from pro-to anti-inflammatory cytokines. Transplantation. 2001;72:1505–1512.

  23. Shudo Y, Miller SL, Boyd JH, Woo YJ. Successful use of donor lungs after repairing severely injured pulmonary vein of donor lungs. Eur J Cardiothorac Surg. 2018;53:889.

    Article  Google Scholar 

  24. Shigemura N, Bhama J, Nguyen D, Thacker J, Bermudez C, Toyoda Y. Pitfalls in donor lung procurements: how should the procedure be taught to transplant trainees? J Thorac Cardiovasc Surg. 2009;138:486–90.

    Article  Google Scholar 

  25. Smail H, Saxena P, Wallinder A, et al. Donor lung procurement by surgical fellow with an expectation of high rate of lung utilisation. Heart Lung Circ. 2018;27:961–6.

    Article  Google Scholar 

  26. MacGowan GA, Dark JH, Corris PA, Nair AR. Effects of drug abuse, smoking and alcohol on donor hearts and lungs. Transpl Int. 2019;32:1019–27.

    Article  Google Scholar 

  27. Copeland H, Hayanga JWA, Neyrinck A, et al. Donor heart and lung procurement: A consensus statement. J Heart Lung Transplant. 2020;39: 501–517.

Download references

Funding

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Prasad Krishnan.

Ethics declarations

Declarations

Permission obtained from Mayo Clinic to use Figures 3 and 4 in article.

Conflict of interest

Nil.

Ethics approval

Not applicable.

Informed consent

Not applicable.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Krishnan, P., Saddoughi, SAS.(. Procurement of lungs from brain-dead donors. Indian J Thorac Cardiovasc Surg 37 (Suppl 3), 416–424 (2021). https://doi.org/10.1007/s12055-021-01140-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12055-021-01140-1

Keywords

Navigation