TY - JOUR
T1 - Donor Lung Referrals for Lung Transplantation
T2 - A ‘Behind The Scenes’ View
AU - Snell, Gregory I.
AU - Levvey, Bronwyn J.
AU - Henriksen, Aimee
AU - Whitford, Helen M.
AU - Levin, Kovi
AU - Paraskeva, Miranda
AU - Kotecha, Sakhee
AU - Williams, Trevor
AU - Westall, Glen P.
AU - McGiffin, David
PY - 2020/5
Y1 - 2020/5
N2 - Background: Australia's increasing organ donor rate has translated to increased lung donor referrals and subsequent lung transplantation (LTx). The LTx sector attempts to utilise as many organs as possible—but in reality, not all are used. This analysis aims to assess the utility and efficiency of donor lung referrals to the Alfred Hospital. Methods: All Donatelife Australia donor lung referrals for the year 2017 were analysed retrospectively. Results: From a total of 440 lung referrals, 220 were local from the state of Victoria (population 6.4 million) and 220 from the Rest-of-Australia (ROA). Sixty-eight per cent (68%) of Victorian and 48% of the ROA were via the donation after circulatory death (DCD) pathway. One hundred and two (102) LTx were performed: 32 represent 21% of 149 Victorian and 8% of 106 ROA DCD donors, 70 represent 54% of the Victorian and 24% of the ROA donation after brain death (DBD) donors. Eighty per cent (80%) of all donors aged <35 and 30% >35 years were used or potentially useable. Thirteen per cent (13%) of DCD and 44% of DBD donors aged >65 years were used. Logistical and resource considerations, around the retrieval of older DCD lungs, are a significant issue. At 11.1 LTx per-million-population the Alfred has one of the highest lung donor conversion and LTx activity rates in the world. Conclusion: The Australian donor lung pool could still be further extended by focussing effort and logistics on optimising DBD referrals. Additional resources (staff and transport), tighter referral criteria, and the use of extended warm ischaemic time donors could increase particularly DCD recovery rates.
AB - Background: Australia's increasing organ donor rate has translated to increased lung donor referrals and subsequent lung transplantation (LTx). The LTx sector attempts to utilise as many organs as possible—but in reality, not all are used. This analysis aims to assess the utility and efficiency of donor lung referrals to the Alfred Hospital. Methods: All Donatelife Australia donor lung referrals for the year 2017 were analysed retrospectively. Results: From a total of 440 lung referrals, 220 were local from the state of Victoria (population 6.4 million) and 220 from the Rest-of-Australia (ROA). Sixty-eight per cent (68%) of Victorian and 48% of the ROA were via the donation after circulatory death (DCD) pathway. One hundred and two (102) LTx were performed: 32 represent 21% of 149 Victorian and 8% of 106 ROA DCD donors, 70 represent 54% of the Victorian and 24% of the ROA donation after brain death (DBD) donors. Eighty per cent (80%) of all donors aged <35 and 30% >35 years were used or potentially useable. Thirteen per cent (13%) of DCD and 44% of DBD donors aged >65 years were used. Logistical and resource considerations, around the retrieval of older DCD lungs, are a significant issue. At 11.1 LTx per-million-population the Alfred has one of the highest lung donor conversion and LTx activity rates in the world. Conclusion: The Australian donor lung pool could still be further extended by focussing effort and logistics on optimising DBD referrals. Additional resources (staff and transport), tighter referral criteria, and the use of extended warm ischaemic time donors could increase particularly DCD recovery rates.
KW - Donation after circulatory death
KW - Lung transplantation
KW - Organ donation
UR - http://www.scopus.com/inward/record.url?scp=85065024208&partnerID=8YFLogxK
U2 - 10.1016/j.hlc.2019.04.007
DO - 10.1016/j.hlc.2019.04.007
M3 - Article
AN - SCOPUS:85065024208
SN - 1443-9506
VL - 29
SP - 793
EP - 799
JO - Heart Lung and Circulation
JF - Heart Lung and Circulation
IS - 5
ER -