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Lung Donor Selection and Management

Departments of ¹ Thoracic Surgery, ² Anaesthesiology, and ³ Pneumology, University Hospital Gasthuisberg, Leuven, Belgium

Correspondence and requests for reprints should be addressed to Dirk Van Raemdonck, M.D., Ph.D., Department of Thoracic Surgery, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. E-mail: dirk.vanraemdonck{at}uzleuven.be

ABSTRACT

Lung transplantation is still limited by the shortage of suitable donor organs. This results in long waiting times for listed patients with a substantial risk (10–15%) of dying before transplantation. All efforts to increase donor awareness through legislation, public campaigns, and training of transplant coordinators and medical ICU staff should be encouraged. Only a minority of cadaveric donors meets the preset ideal lung donor criteria, leaving many transplantable lungs untouched. Donor lung utilization can be further improved by careful selection of extended criteria donors, by active participation of transplant teams in donor management, and by verifying as often as possible the quality of lungs in the donor hospital by a member of the transplant team. This article aims to update the current evidence from the literature to identify and select potential lung donors and to manage cadaveric donors to maximally increase the organ yield for lung transplantation.

Key Words: lung transplantation • extended criteria • organ donor • donor management