International Society for Heart and Lung Transplantation Donation after Circulatory Death Registry Report

Marcelo Cypel, Bronwyn Levvey, Dirk Van Raemdonck, Michiel Erasmus, John Dark, Robert Love, David Mason, Allan R. Glanville, Daniel Chambers, Leah B. Edwards, Josef Stehlik, Marshall Hertz, Brian A. Whitson, Roger D. Yusen, Varun Puri, Peter Hopkins, Greg Snell, Shaf Keshavjee

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

Background The objective of this study was to review the international experience in lung transplantation using lung donation after circulatory death (DCD). Methods In this retrospective study, data from the International Society for Heart and Lung Transplantation (ISHLT) DCD Registry were analyzed. The study cohort included DCD lung transplants performed between January 2003 and June 2013, and reported to the ISHLT DCD Registry as of April 2014. The participating institutions included 10 centers in North America, Europe and Australia. The control group was a cohort of lung recipients transplanted using brain-dead donors (DBDs) during the same study period. The primary end-point was survival after lung transplantation. Results There were 306 transplants performed using DCD donors and 3,992 transplants using DBD donors during the study period. Of the DCD transplants, 94.8% were Maastricht Category III, whereas 4% were Category IV and 1.2% Category V (euthanasia). Heparin was given in 54% of the cases, donor extubation occurred in 90% of the cases, and normothermic ex vivo lung perfusion (EVLP) was used in 12%. The median time from withdrawal of life support therapy (WLST) to cardiac arrest was 15 minutes (5th to 95th percentiles of 5 to 55 minutes), and from WLST to cold flush was 33 minutes (5th to 95th percentiles of 19.5 to 79.5 minutes). Recipient age and medical diagnosis were similar in DCD and DBD groups (p = not significant [NS]). Median hospital length of stay was 18 days in DCD lung transplants and 16 days in DBD transplants (p = 0.016). Thirty-day survival was 96% in the DCD group and 97% in the DBD group. One-year survival was 89% in the DCD group and 88% in the DBD group (p = NS). Five-year survival was 61% in both groups (p = NS). The mechanism of donor death within the DCD group seemed to influence recipient early survival. The survival rates through 30 days were significantly different by donor mechanism of death (p = 0.0152). There was no significant correlation between the interval of WLST to pulmonary flush with survival (p = 0.11). Conclusion This large study of international, multi-center experience demonstrates excellent survival after lung transplantation using DCD donors. It should be further evaluated whether the mechanism of donor death influences survival after DCD transplant.

Original languageEnglish (US)
Pages (from-to)1278-1282
Number of pages5
JournalJournal of Heart and Lung Transplantation
Volume34
Issue number10
DOIs
StatePublished - Oct 1 2015

Fingerprint

Registries
Transplants
Lung
Lung Transplantation
Length of Stay
Heart-Lung Transplantation
Cryotherapy
Brain Death
Euthanasia
North America
Heart Arrest
Heparin
Cohort Studies
Survival Rate
Retrospective Studies
Perfusion

Keywords

  • allograft ischemic time
  • donation after circulatory death
  • donor lungs allograft
  • lung transplantation
  • mortality risk factors
  • survival

Cite this

International Society for Heart and Lung Transplantation Donation after Circulatory Death Registry Report. / Cypel, Marcelo; Levvey, Bronwyn; Van Raemdonck, Dirk; Erasmus, Michiel; Dark, John; Love, Robert; Mason, David; Glanville, Allan R.; Chambers, Daniel; Edwards, Leah B.; Stehlik, Josef; Hertz, Marshall; Whitson, Brian A.; Yusen, Roger D.; Puri, Varun; Hopkins, Peter; Snell, Greg; Keshavjee, Shaf.

In: Journal of Heart and Lung Transplantation, Vol. 34, No. 10, 01.10.2015, p. 1278-1282.

Research output: Contribution to journalArticle

Cypel, M, Levvey, B, Van Raemdonck, D, Erasmus, M, Dark, J, Love, R, Mason, D, Glanville, AR, Chambers, D, Edwards, LB, Stehlik, J, Hertz, M, Whitson, BA, Yusen, RD, Puri, V, Hopkins, P, Snell, G & Keshavjee, S 2015, 'International Society for Heart and Lung Transplantation Donation after Circulatory Death Registry Report', Journal of Heart and Lung Transplantation, vol. 34, no. 10, pp. 1278-1282. https://doi.org/10.1016/j.healun.2015.08.015
Cypel, Marcelo ; Levvey, Bronwyn ; Van Raemdonck, Dirk ; Erasmus, Michiel ; Dark, John ; Love, Robert ; Mason, David ; Glanville, Allan R. ; Chambers, Daniel ; Edwards, Leah B. ; Stehlik, Josef ; Hertz, Marshall ; Whitson, Brian A. ; Yusen, Roger D. ; Puri, Varun ; Hopkins, Peter ; Snell, Greg ; Keshavjee, Shaf. / International Society for Heart and Lung Transplantation Donation after Circulatory Death Registry Report. In: Journal of Heart and Lung Transplantation. 2015 ; Vol. 34, No. 10. pp. 1278-1282.
@article{606bcbf7575e4f7ca695104e9db2c299,
title = "International Society for Heart and Lung Transplantation Donation after Circulatory Death Registry Report",
abstract = "Background The objective of this study was to review the international experience in lung transplantation using lung donation after circulatory death (DCD). Methods In this retrospective study, data from the International Society for Heart and Lung Transplantation (ISHLT) DCD Registry were analyzed. The study cohort included DCD lung transplants performed between January 2003 and June 2013, and reported to the ISHLT DCD Registry as of April 2014. The participating institutions included 10 centers in North America, Europe and Australia. The control group was a cohort of lung recipients transplanted using brain-dead donors (DBDs) during the same study period. The primary end-point was survival after lung transplantation. Results There were 306 transplants performed using DCD donors and 3,992 transplants using DBD donors during the study period. Of the DCD transplants, 94.8{\%} were Maastricht Category III, whereas 4{\%} were Category IV and 1.2{\%} Category V (euthanasia). Heparin was given in 54{\%} of the cases, donor extubation occurred in 90{\%} of the cases, and normothermic ex vivo lung perfusion (EVLP) was used in 12{\%}. The median time from withdrawal of life support therapy (WLST) to cardiac arrest was 15 minutes (5th to 95th percentiles of 5 to 55 minutes), and from WLST to cold flush was 33 minutes (5th to 95th percentiles of 19.5 to 79.5 minutes). Recipient age and medical diagnosis were similar in DCD and DBD groups (p = not significant [NS]). Median hospital length of stay was 18 days in DCD lung transplants and 16 days in DBD transplants (p = 0.016). Thirty-day survival was 96{\%} in the DCD group and 97{\%} in the DBD group. One-year survival was 89{\%} in the DCD group and 88{\%} in the DBD group (p = NS). Five-year survival was 61{\%} in both groups (p = NS). The mechanism of donor death within the DCD group seemed to influence recipient early survival. The survival rates through 30 days were significantly different by donor mechanism of death (p = 0.0152). There was no significant correlation between the interval of WLST to pulmonary flush with survival (p = 0.11). Conclusion This large study of international, multi-center experience demonstrates excellent survival after lung transplantation using DCD donors. It should be further evaluated whether the mechanism of donor death influences survival after DCD transplant.",
keywords = "allograft ischemic time, donation after circulatory death, donor lungs allograft, lung transplantation, mortality risk factors, survival",
author = "Marcelo Cypel and Bronwyn Levvey and {Van Raemdonck}, Dirk and Michiel Erasmus and John Dark and Robert Love and David Mason and Glanville, {Allan R.} and Daniel Chambers and Edwards, {Leah B.} and Josef Stehlik and Marshall Hertz and Whitson, {Brian A.} and Yusen, {Roger D.} and Varun Puri and Peter Hopkins and Greg Snell and Shaf Keshavjee",
year = "2015",
month = "10",
day = "1",
doi = "10.1016/j.healun.2015.08.015",
language = "English (US)",
volume = "34",
pages = "1278--1282",
journal = "Journal of Heart and Lung Transplantation",
issn = "1053-2498",
publisher = "Elsevier USA",
number = "10",

}

TY - JOUR

T1 - International Society for Heart and Lung Transplantation Donation after Circulatory Death Registry Report

AU - Cypel, Marcelo

AU - Levvey, Bronwyn

AU - Van Raemdonck, Dirk

AU - Erasmus, Michiel

AU - Dark, John

AU - Love, Robert

AU - Mason, David

AU - Glanville, Allan R.

AU - Chambers, Daniel

AU - Edwards, Leah B.

AU - Stehlik, Josef

AU - Hertz, Marshall

AU - Whitson, Brian A.

AU - Yusen, Roger D.

AU - Puri, Varun

AU - Hopkins, Peter

AU - Snell, Greg

AU - Keshavjee, Shaf

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Background The objective of this study was to review the international experience in lung transplantation using lung donation after circulatory death (DCD). Methods In this retrospective study, data from the International Society for Heart and Lung Transplantation (ISHLT) DCD Registry were analyzed. The study cohort included DCD lung transplants performed between January 2003 and June 2013, and reported to the ISHLT DCD Registry as of April 2014. The participating institutions included 10 centers in North America, Europe and Australia. The control group was a cohort of lung recipients transplanted using brain-dead donors (DBDs) during the same study period. The primary end-point was survival after lung transplantation. Results There were 306 transplants performed using DCD donors and 3,992 transplants using DBD donors during the study period. Of the DCD transplants, 94.8% were Maastricht Category III, whereas 4% were Category IV and 1.2% Category V (euthanasia). Heparin was given in 54% of the cases, donor extubation occurred in 90% of the cases, and normothermic ex vivo lung perfusion (EVLP) was used in 12%. The median time from withdrawal of life support therapy (WLST) to cardiac arrest was 15 minutes (5th to 95th percentiles of 5 to 55 minutes), and from WLST to cold flush was 33 minutes (5th to 95th percentiles of 19.5 to 79.5 minutes). Recipient age and medical diagnosis were similar in DCD and DBD groups (p = not significant [NS]). Median hospital length of stay was 18 days in DCD lung transplants and 16 days in DBD transplants (p = 0.016). Thirty-day survival was 96% in the DCD group and 97% in the DBD group. One-year survival was 89% in the DCD group and 88% in the DBD group (p = NS). Five-year survival was 61% in both groups (p = NS). The mechanism of donor death within the DCD group seemed to influence recipient early survival. The survival rates through 30 days were significantly different by donor mechanism of death (p = 0.0152). There was no significant correlation between the interval of WLST to pulmonary flush with survival (p = 0.11). Conclusion This large study of international, multi-center experience demonstrates excellent survival after lung transplantation using DCD donors. It should be further evaluated whether the mechanism of donor death influences survival after DCD transplant.

AB - Background The objective of this study was to review the international experience in lung transplantation using lung donation after circulatory death (DCD). Methods In this retrospective study, data from the International Society for Heart and Lung Transplantation (ISHLT) DCD Registry were analyzed. The study cohort included DCD lung transplants performed between January 2003 and June 2013, and reported to the ISHLT DCD Registry as of April 2014. The participating institutions included 10 centers in North America, Europe and Australia. The control group was a cohort of lung recipients transplanted using brain-dead donors (DBDs) during the same study period. The primary end-point was survival after lung transplantation. Results There were 306 transplants performed using DCD donors and 3,992 transplants using DBD donors during the study period. Of the DCD transplants, 94.8% were Maastricht Category III, whereas 4% were Category IV and 1.2% Category V (euthanasia). Heparin was given in 54% of the cases, donor extubation occurred in 90% of the cases, and normothermic ex vivo lung perfusion (EVLP) was used in 12%. The median time from withdrawal of life support therapy (WLST) to cardiac arrest was 15 minutes (5th to 95th percentiles of 5 to 55 minutes), and from WLST to cold flush was 33 minutes (5th to 95th percentiles of 19.5 to 79.5 minutes). Recipient age and medical diagnosis were similar in DCD and DBD groups (p = not significant [NS]). Median hospital length of stay was 18 days in DCD lung transplants and 16 days in DBD transplants (p = 0.016). Thirty-day survival was 96% in the DCD group and 97% in the DBD group. One-year survival was 89% in the DCD group and 88% in the DBD group (p = NS). Five-year survival was 61% in both groups (p = NS). The mechanism of donor death within the DCD group seemed to influence recipient early survival. The survival rates through 30 days were significantly different by donor mechanism of death (p = 0.0152). There was no significant correlation between the interval of WLST to pulmonary flush with survival (p = 0.11). Conclusion This large study of international, multi-center experience demonstrates excellent survival after lung transplantation using DCD donors. It should be further evaluated whether the mechanism of donor death influences survival after DCD transplant.

KW - allograft ischemic time

KW - donation after circulatory death

KW - donor lungs allograft

KW - lung transplantation

KW - mortality risk factors

KW - survival

UR - http://www.scopus.com/inward/record.url?scp=84943227359&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84943227359&partnerID=8YFLogxK

U2 - 10.1016/j.healun.2015.08.015

DO - 10.1016/j.healun.2015.08.015

M3 - Article

C2 - 26454741

AN - SCOPUS:84943227359

VL - 34

SP - 1278

EP - 1282

JO - Journal of Heart and Lung Transplantation

JF - Journal of Heart and Lung Transplantation

SN - 1053-2498

IS - 10

ER -