Survival rates of lung transplant recipients who received donations after cardiac death were favorable at 1 month and 1 year after transplant, and were comparable to rates in recipients who received donations after brain death.
Researchers reported results from the first multicenter study to evaluate outcomes in a large number of cases using the recently established Donation After Cardiac Death International Society for Heart and Lung Transplantation registry. Researchers analyzed data collected at nine centers in North America, Europe and Australia from January 2003 to August 2012. Researchers reviewed 244 transplants using donation after cardiac death lungs and survival of these patients was compared with 2,744 transplants using donation after brain death, according to a press release.
The primary endpoint was 1-year post-lung transplant survival using donations after cardiac death vs. donations after brain death. Thirty-day survival was 97% in both transplant groups. One-year survival was 88% in the donation after brain death group vs. 89% in the donation after cardiac death group. According to the researchers, “the mechanism of donor death in the donation after cardiac death group seemed to influence early recipient survival.” All 30-day deaths occurred in transplants from donors with head trauma. One-year survival rates were 95% for anoxic injury, 90% for cerebrovascular events and 85% for head trauma, according to the abstract.
In other results, median time from withdrawal of life-sustaining treatments to cardiac arrest was 15 minutes and time from withdrawal to cold flush was 32 minutes. Median length of hospital stay was 18 days in the donation after cardiac death group vs. 16 days in the donation after brain death group. Forty-eight percent of patients in the donation after cardiac death group were administered heparin, 87% donor extubation and 13% ex vivo lung fusion.
Researchers reported a marked increase in donation after cardiac death lung transplantation from 2003 to 2012. More than 95% of cases were Maastricht category III, 2.7% category IV and 1.8% category V. Donations after brain death remained stable during the study period. Age and medical diagnoses were similar in both the cardiac death and brain death donation groups, according to the abstract.
“What we’ve learned from this multicenter study is that the survival rates were excellent in the donation after cardiac death group with 97% at 1 month and 89% at 1 years,” Marcelo Cypel, MD, assistant professor of surgery at University of Toronto and Toronto General Hospital, Canada, said in a press release. “These rates are comparable to donation after brain death rates and support the notion that donation after cardiac death should be seen as a viable source for organ donation.”
For more information:
Cypel M. Abstract #16. Presented at: International Society for Heart and Lung Transplantation Annual Meeting and Scientific Sessions; April 24-27, 2013; Montreal.
Disclosure: Cypel reports no relevant financial disclosures.