(930) Comparing Lung Donation after Circulatory Death to Donation after Brain Death in a Single Australian Centre

PurposeLungs obtained through the donation-after-circulatory death (DCD) pathway provide a vital addition to the available organ pool. Conflicting findings have been published regarding the ‘marginality’ of these organs, with some jurisdictions evaluating the bulk of DCD lungs ex-vivo prior to transplantation. This paper compares mortality in patients who received lungs through the DCD pathway to the donation after brain death (DBD) pathway in a single Australian centre. None of the lungs included were evaluated ex-vivo.MethodsPatient data for all lung recipients between January 2010 and October 2022 was extracted from the transplant database. This included demographics as well as perioperative variables. All patients who had received lungs through the DCD pathway were identified and compared to their DBD counterparts. Statistical analysis was undertaken using SPSS v21.Results490 lung transplants were conducted, including 482 bilateral and 8 right single lung transplants. 110 (22%) organs were obtained through the DCD pathway. There was no significant difference in donor age or BMI between the two groups. Donor P/F ratio was 414 (Range 182-614) in the DCD group and 425 (Range 150-618) in the DBD group, p=NS. Similarly, there was no significant difference in recipient age, recipient BMI, lung pathology or ischaemic time between the two groups. 90-Day Mortality was 16 (4%) in the DBD group and 10 (10%) in the DCD group, p=0.054). There was no difference in post-operatively survival on Kaplan-Meier analysis, p=0.604 (Log-Rank test).ConclusionOur data demonstrates that patients who received lungs through the DCD pathway had similar post-operative and long-term mortality to their DBD counterparts. These findings support the fact that DCD lungs should not be considered marginal solely based on donation pathway. Lungs obtained through the donation-after-circulatory death (DCD) pathway provide a vital addition to the available organ pool. Conflicting findings have been published regarding the ‘marginality’ of these organs, with some jurisdictions evaluating the bulk of DCD lungs ex-vivo prior to transplantation. This paper compares mortality in patients who received lungs through the DCD pathway to the donation after brain death (DBD) pathway in a single Australian centre. None of the lungs included were evaluated ex-vivo. Patient data for all lung recipients between January 2010 and October 2022 was extracted from the transplant database. This included demographics as well as perioperative variables. All patients who had received lungs through the DCD pathway were identified and compared to their DBD counterparts. Statistical analysis was undertaken using SPSS v21. 490 lung transplants were conducted, including 482 bilateral and 8 right single lung transplants. 110 (22%) organs were obtained through the DCD pathway. There was no significant difference in donor age or BMI between the two groups. Donor P/F ratio was 414 (Range 182-614) in the DCD group and 425 (Range 150-618) in the DBD group, p=NS. Similarly, there was no significant difference in recipient age, recipient BMI, lung pathology or ischaemic time between the two groups. 90-Day Mortality was 16 (4%) in the DBD group and 10 (10%) in the DCD group, p=0.054). There was no difference in post-operatively survival on Kaplan-Meier analysis, p=0.604 (Log-Rank test). Our data demonstrates that patients who received lungs through the DCD pathway had similar post-operative and long-term mortality to their DBD counterparts. These findings support the fact that DCD lungs should not be considered marginal solely based on donation pathway.