Introduction
Uncontrolled donation after cardiac death (DACD) has become an alternative to lung transplantation with encephalic-death donation. The main objective of this study is to describe the incidence of clinically relevant events in the period of 30 days after lung transplant with
uncontrolled DACD and the influence of factors depending on the donor and donation process as well.
Patients and methods
Historical cohort study of 33 lung transplant receivers at Hospital Puerta de Hierro and Hospital Marqu¨¦s de Valdecilla with 32 DACD from Hospital Cl¨ªnico San Carlos from 2002 to 2008. We studied surgical and medical complications, primary graft dysfunction, acute rejection, pneumonia, and mortality. We made an evaluation of the donor characteristics and donation procedure times (min).
Results
Median age of recipients was 50.5 years (interquartile range, 38.5?8). There were 28 males and 5 females. Cumulative incidence of events in the first month was: pneumonia, 10 (31.3 % ); primary graft dysfunction, 15 (46.9 % ); rejection, 12 (37.5 % ); mortality, 4 (12.1 % ); medical complications, 25 (78.1 % ); and surgical complications, 18 (56.3 % ). Median time of cardiac arrest was higher in those who presented pneumonia (15 vs 7.5; P=.027). Median time of cold ischemia was higher in those who presented surgical complications and mortality (436 vs 343.5; P=.04; 505 vs 410; P=.033, respectively), and median of total ischemia times were longer in the recipients who died (828 vs 695; P=.036).
Conclusions
Uncontrolled DACD is a valid alternative for expanding the donor pool in order to mitigate the current shortage of lungs that are valid for transplantation. The incidence of complications is comparable with published data in the literature.
