(718) Multiorgan Donor Bronchoalveolar Lavage Positivity: Incidence, Risk Factors, and Lung Transplant Recipients’ Outcome

PurposeTo evaluate the incidence and risk factors for bronchoalveolar lavage (BAL) positivity in lung donors. To measure the rate of donor derived infections (DDI) and the effect of BAL positivity on lung transplant (LuTX) recipients’ outcome.MethodsRetrospective single center analysis of consecutive LuTX from January 2018 to December 2021. BAL samples were obtained from donors’ lungs immediately ahead harvesting and from recipients’ lungs at three times after LuTX: day 1-3, 7, and 14. BAL positivity was defined as bacterial growth ≥104 colony forming units. A DDI was defined as growth of the same bacterial species between the donor and the recipient BAL. Recipients’ cohort was divided between colonized and not-colonized subjects based on the presence of pre-transplant colonizing disease. Recipients’ duration of mechanical ventilation, intensive care unit and hospital length of stay were assessed.Results100 LuTX procedures were analyzed out of 104 LuTX performed along the study period. 42 (42%) of donor BAL were positive for at least one bacterial species: Staphylococcus Aureus and Enterobacterales were the predominant causative pathogens. Donors’ age, sex, cause of death, duration of mechanical ventilation, and PaO2/FiO2 were not correlated to occurrence of the BAL positive result. Figure 1 illustrates the recipients’ BAL results course along the first two weeks after LuTX. Three cases of DDI were detected accounting for 3.4% of all LuTX. No effect was detected in recipients’ outcome neither among the colonized and not-colonized cohort.ConclusionIn the present cohort the incidence of positive BAL coltures among lung donors is about 40% and donor characteristics available at the time of harvesting are unable to predict donor BAL positivity. Donor BAL positivity does not affect recipients’ outcomes. To evaluate the incidence and risk factors for bronchoalveolar lavage (BAL) positivity in lung donors. To measure the rate of donor derived infections (DDI) and the effect of BAL positivity on lung transplant (LuTX) recipients’ outcome. Retrospective single center analysis of consecutive LuTX from January 2018 to December 2021. BAL samples were obtained from donors’ lungs immediately ahead harvesting and from recipients’ lungs at three times after LuTX: day 1-3, 7, and 14. BAL positivity was defined as bacterial growth ≥104 colony forming units. A DDI was defined as growth of the same bacterial species between the donor and the recipient BAL. Recipients’ cohort was divided between colonized and not-colonized subjects based on the presence of pre-transplant colonizing disease. Recipients’ duration of mechanical ventilation, intensive care unit and hospital length of stay were assessed. 100 LuTX procedures were analyzed out of 104 LuTX performed along the study period. 42 (42%) of donor BAL were positive for at least one bacterial species: Staphylococcus Aureus and Enterobacterales were the predominant causative pathogens. Donors’ age, sex, cause of death, duration of mechanical ventilation, and PaO2/FiO2 were not correlated to occurrence of the BAL positive result. Figure 1 illustrates the recipients’ BAL results course along the first two weeks after LuTX. Three cases of DDI were detected accounting for 3.4% of all LuTX. No effect was detected in recipients’ outcome neither among the colonized and not-colonized cohort. In the present cohort the incidence of positive BAL coltures among lung donors is about 40% and donor characteristics available at the time of harvesting are unable to predict donor BAL positivity. Donor BAL positivity does not affect recipients’ outcomes.