Donation after circulatory death with thoracoabdominal normothermic regional perfusion recovery has similar outcomes with donation after brain death for lung transplantation
Introduction: Donation after circulatory death (DCD) with thoracoabdominal normothermic regional perfusion (TA-NRP) has been increasingly used to procure cardiac allografts; however, concerns persist regarding its impact on lung allografts. We present our institution’s experience with DCD TA-NRP and...
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| Language: | English |
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Elsevier
2025-08-01
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| Series: | JHLT Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950133425000849 |
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| author | Sarah Y. Park, MD Emily Hay-Arthur, BA Elizabeth J. Bashian, MD Han Le, MS Michal Schäfer, MD, PhD David N. Campbell, MD Nicholas R. Teman, MD Alice L. Gray, MD Jordan R.H. Hoffman, MD, MPH Michael T. Cain, MD |
| author_facet | Sarah Y. Park, MD Emily Hay-Arthur, BA Elizabeth J. Bashian, MD Han Le, MS Michal Schäfer, MD, PhD David N. Campbell, MD Nicholas R. Teman, MD Alice L. Gray, MD Jordan R.H. Hoffman, MD, MPH Michael T. Cain, MD |
| author_sort | Sarah Y. Park, MD |
| collection | DOAJ |
| description | Introduction: Donation after circulatory death (DCD) with thoracoabdominal normothermic regional perfusion (TA-NRP) has been increasingly used to procure cardiac allografts; however, concerns persist regarding its impact on lung allografts. We present our institution’s experience with DCD TA-NRP and donation after brain death (DBD) lung transplants, comparing outcomes between the two techniques. Methods: All lung transplants recovered with DBD or DCD TA-NRP performed between October 2022 and December 2024 were included. DCD TA-NRP procured lungs were retrieved using a lung protective strategy including early reintubation and pulmonary venting as previously described. The primary outcome was survival, with secondary outcomes of primary graft dysfunction (PGD) and pulmonary-related mortality. Results: There were 85 DBD and 23 DCD TA-NRP lung transplants performed in the study period. Overall survival was not significantly different by Kaplan-Meier curve (p = 0.49), with 1-year absolute survival of 81.6% for DCD TA-NRP, with only one pulmonary-related mortality, and 89.4% for DBD, with six pulmonary-related mortalities. PGD grade 3 rates were not statistically different at postoperative day (POD) 0 (47.8% DCD TA-NRP vs 35.2% DBD, p = 0.27), POD 1 (21.7% vs 10.6%, p = 0.16), POD2 (8.7% vs 11.7%, p = 0.68), and POD3 (13.0% vs 11.8%, p = 0.87). Other intraoperative and postoperative outcomes were not significantly different. Conclusion: Lung transplantation outcomes were not significantly different between lung grafts recovered by DCD TA-NRP and DBD. This early data suggests TA-NRP may not adversely impact DCD lung allografts during procurement. |
| format | Article |
| id | doaj-art-691246f31dcd44f79c900c4f38c7a5f5 |
| institution | Kabale University |
| issn | 2950-1334 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHLT Open |
| spelling | doaj-art-691246f31dcd44f79c900c4f38c7a5f52025-08-20T04:01:48ZengElsevierJHLT Open2950-13342025-08-01910028910.1016/j.jhlto.2025.100289Donation after circulatory death with thoracoabdominal normothermic regional perfusion recovery has similar outcomes with donation after brain death for lung transplantationSarah Y. Park, MD0Emily Hay-Arthur, BA1Elizabeth J. Bashian, MD2Han Le, MS3Michal Schäfer, MD, PhD4David N. Campbell, MD5Nicholas R. Teman, MD6Alice L. Gray, MD7Jordan R.H. Hoffman, MD, MPH8Michael T. Cain, MD9Department of Surgery, Division of Cardiothoracic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CODepartment of Surgery, Division of Cardiothoracic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CODepartment of Surgery, Division of Cardiothoracic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CODepartment of Surgery, Division of Cardiothoracic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CODepartment of Surgery, Division of Cardiothoracic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CODepartment of Surgery, Division of Cardiothoracic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CODepartment of Surgery, Division of Cardiothoracic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CODepartment of Medicine, Division of Pulmonary Sciences and Critical Care, University of Colorado Anschutz Medical Campus, Aurora, CODepartment of Surgery, Division of Cardiothoracic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CODepartment of Surgery, Division of Cardiothoracic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO; Corresponding author: Michael T. Cain, MD, Mail Stop C310, 12631 East 17th Avenue, Room 6602, Aurora, CO 80045.Introduction: Donation after circulatory death (DCD) with thoracoabdominal normothermic regional perfusion (TA-NRP) has been increasingly used to procure cardiac allografts; however, concerns persist regarding its impact on lung allografts. We present our institution’s experience with DCD TA-NRP and donation after brain death (DBD) lung transplants, comparing outcomes between the two techniques. Methods: All lung transplants recovered with DBD or DCD TA-NRP performed between October 2022 and December 2024 were included. DCD TA-NRP procured lungs were retrieved using a lung protective strategy including early reintubation and pulmonary venting as previously described. The primary outcome was survival, with secondary outcomes of primary graft dysfunction (PGD) and pulmonary-related mortality. Results: There were 85 DBD and 23 DCD TA-NRP lung transplants performed in the study period. Overall survival was not significantly different by Kaplan-Meier curve (p = 0.49), with 1-year absolute survival of 81.6% for DCD TA-NRP, with only one pulmonary-related mortality, and 89.4% for DBD, with six pulmonary-related mortalities. PGD grade 3 rates were not statistically different at postoperative day (POD) 0 (47.8% DCD TA-NRP vs 35.2% DBD, p = 0.27), POD 1 (21.7% vs 10.6%, p = 0.16), POD2 (8.7% vs 11.7%, p = 0.68), and POD3 (13.0% vs 11.8%, p = 0.87). Other intraoperative and postoperative outcomes were not significantly different. Conclusion: Lung transplantation outcomes were not significantly different between lung grafts recovered by DCD TA-NRP and DBD. This early data suggests TA-NRP may not adversely impact DCD lung allografts during procurement.http://www.sciencedirect.com/science/article/pii/S2950133425000849Donation after circulatory deathLung transplantationNormothermic regional perfusionDonation after brain deathPrimary graft dysfunction |
| spellingShingle | Sarah Y. Park, MD Emily Hay-Arthur, BA Elizabeth J. Bashian, MD Han Le, MS Michal Schäfer, MD, PhD David N. Campbell, MD Nicholas R. Teman, MD Alice L. Gray, MD Jordan R.H. Hoffman, MD, MPH Michael T. Cain, MD Donation after circulatory death with thoracoabdominal normothermic regional perfusion recovery has similar outcomes with donation after brain death for lung transplantation JHLT Open Donation after circulatory death Lung transplantation Normothermic regional perfusion Donation after brain death Primary graft dysfunction |
| title | Donation after circulatory death with thoracoabdominal normothermic regional perfusion recovery has similar outcomes with donation after brain death for lung transplantation |
| title_full | Donation after circulatory death with thoracoabdominal normothermic regional perfusion recovery has similar outcomes with donation after brain death for lung transplantation |
| title_fullStr | Donation after circulatory death with thoracoabdominal normothermic regional perfusion recovery has similar outcomes with donation after brain death for lung transplantation |
| title_full_unstemmed | Donation after circulatory death with thoracoabdominal normothermic regional perfusion recovery has similar outcomes with donation after brain death for lung transplantation |
| title_short | Donation after circulatory death with thoracoabdominal normothermic regional perfusion recovery has similar outcomes with donation after brain death for lung transplantation |
| title_sort | donation after circulatory death with thoracoabdominal normothermic regional perfusion recovery has similar outcomes with donation after brain death for lung transplantation |
| topic | Donation after circulatory death Lung transplantation Normothermic regional perfusion Donation after brain death Primary graft dysfunction |
| url | http://www.sciencedirect.com/science/article/pii/S2950133425000849 |
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