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Initial Experience of Lung Transplantation Using Voluntary Organ Donations after Brain and Cardiac Death of Citizens at Wuxi Center: tough sail in 2015

Mao, Wenjun; Chen, Jingyu

doi: 10.1097/01.tp.0000520372.61075.6a
211.10
Free

Department of Lung Transplant Center, Key Laboratory of Human Organ Transplant in Jiangsu Province, Affiliated Wuxi People’s Hospital, Nanjing Medical University, Wuxi, People's Republic of China.

Wuxi Lung transplant center.

Introduction: The purpose of the study was to estimate the initial experience in lung transplantation using lungs from donation after brain and cardiac death (DBCD) or donation after brain death (DBD) in china.

Methods: Retrospective data from Chinese network registry for lung transplantation performed in our center were evaluated between January and December, 2015. Characteristics of donors and recipients were reviewed.

Results: A total of 103 cases donated their lungs, including 69 DBDs and 34 DBCDs, the main causes of death were 49 (48%) cases of craniocerebral trauma and 54 (52%)cases of celebral vascular incidence. The mean age for these donors were 33.41 (15–57) years old, with a mean ventilation time of 3.77 (1–15) days in the intensive care unit. Two days were frequently required for us to perform organ procurement, and it was hard to transport the donor lungs to our center in China, such as 1–4 hours by highway, 4–6 by highway and high-speed rail, 5.5-9.5 hours are needed by civil aviation, high-speed rail, and highway. There were 107 lung transplantation performed using lungs from DBCD or DBD for 106 patients during the study period. The mean age of recipients was 53.68 (13–73) years old. Eighty patients were males and 27 were females, 75 patients received bilateral lung transplantation, 23 underwent right single lung transplantation, and the remaining 9 received left single lung transplantation, including 2 cases of bilateral split lobar transplantations, 3 secondary lung transplantations for bronchiolitis obliterans, and 1 secondary lung transplantation for severe primary graft dysfunction. The main indications of the cohort includes 53 cases of idiopathic pulmonary fibrosis, 17 chronic obstructive pulmonary disease, 13 silicosis, 11 bronchiectasis, 5 lymphangioleiomyomatosis, 3 bronchiolitis obliterans, and 2 graft versus host lung disease after allogenic hematopoietic stem cell transplantation, 1 eisenmenger syndrome, and 1 chronic pulmonary embolism. Extracorporeal membrane oxygenation(ECMO) was utilized in 44.3% of the patients (47 cases), with 36 recipients weaned from ECMO immediately after transplants. There were 15 death during perioperative period, early survival of 3-month and 6-month were 85.84% and 83.19%, respectively.

Conclusion: This small restrospective study shows that current lung transplant program may expand donors after DBCD and DBD in China with considerable difficulties.

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