Procurement of lungs for transplantation following donation after circulatory death: the Alfred technique

J Surg Res. 2014 Dec;192(2):642-6. doi: 10.1016/j.jss.2014.07.063. Epub 2014 Aug 4.

Abstract

Introduction: Donation after circulatory death (DCD) is an evolving method for lung transplantation (LTx) with results comparable to donation after brain death (DBD).

Materials and methods: DCD lung transplant program requires a systematic approach for an efficient utilization of hospital resources. The surgical techniques have been developed to minimize the ischemic time during lung procurement. We have presented our management protocol and the surgical techniques as used at the Alfred Hospital in Melbourne, Australia.

Results: We have transplanted 92 recipients with lungs procured from 91 donors over an 8 year period from May 2006 to July 2014. This accounted for an extra 19% lung transplant operations performed during this time period. Operative mortality was 1% and 8 year survival was 71% in DCD lung recipients.

Conclusions: DCD lung transplantation provides an additional significant pool of lung donors with satisfactory short and long term outcomes.

Keywords: Donation after circulatory death; Lung transplantation; Pulmonary flush solution.

MeSH terms

  • Citrates / pharmacology
  • Cryopreservation / methods
  • Death
  • Graft Survival
  • Humans
  • Lung Transplantation / methods*
  • Lung Transplantation / mortality*
  • Organ Preservation Solutions / pharmacology
  • Perfusion / methods
  • Reperfusion Injury / mortality*
  • Reperfusion Injury / prevention & control*
  • Tissue Preservation / methods
  • Tissue and Organ Harvesting / methods*
  • Tissue and Organ Procurement / methods*

Substances

  • Citrates
  • Organ Preservation Solutions
  • Perfadex