Impact of extended-criteria donor lungs according to preoperative recipient status and age in lung transplantation
Background : Organ donor shortage remains as one of the limiting factors for lung transplantation. Given the increase in waiting time, preoperative condition has worsened and affects surgical outcomes. This study aimed to evaluate the immediate postoperative and long-term outcomes of lung transplant...
Ausführliche Beschreibung
Autor*in: |
Jee Won Suh [verfasserIn] Jin Gu Lee [verfasserIn] Moo Suk Park [verfasserIn] Song Yee Kim [verfasserIn] Su Jin Jeong [verfasserIn] Hyo Chae Paik [verfasserIn] |
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E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2020 |
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Übergeordnetes Werk: |
In: Korean Journal of Transplantation - Korean Society for Transplantation, 2019, 34(2020), 3, Seite 185-192 |
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Übergeordnetes Werk: |
volume:34 ; year:2020 ; number:3 ; pages:185-192 |
Links: |
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DOI / URN: |
10.4285/kjt.2020.34.3.185 |
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Katalog-ID: |
DOAJ028114698 |
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520 | |a Background : Organ donor shortage remains as one of the limiting factors for lung transplantation. Given the increase in waiting time, preoperative condition has worsened and affects surgical outcomes. This study aimed to evaluate the immediate postoperative and long-term outcomes of lung transplantation in extended-criteria donor (ECD) lungs compared with standard-criteria donor (SCD) lungs. Methods : A total of 246 patients who had undergone double-lung transplantation during the study period were enrolled. SCD was defined based on the following characteristics: age <55 years, <20 pack-years smoking history, and PaO2/fraction of O2 ratio <300 mmHg. Organ donors who do not fulfill these criteria were classified as ECD. Pre- and postoperative data for outcomes and survival data were analyzed. Results : ECD showed significant association with extracorporeal membrane oxygenation weaning in the operating room (hazard ratio [HR], 0.531; 95% confidence interval [CI], 0.291–0.970; P=0.039) considering recipient’s age and status at operation. The ECD group showed comparable survival rate with the SCD group (HR, 1.413; 95% CI, 0.885– 2.255; P=0.148), with adjustment of other factors. However, when the recipient had Korean Network for Organ Sharing (KONOS) status 0 at the time of transplantation (HR, 1.662; 95% CI, 1.025–2.568; P=0.039), G3 primary graft dysfunction at 72 hours after surgery (HR, 2.508; 95% CI, 1.416–4.440; P=0.002) was a risk factor that decreased survival. Conclusions: The outcome of ECD is not inferior to that of SCD. Therefore, ECD lung should be considered a potential donor organ following active donor management rather than a contraindication of transplantation in highly selected recipients. | ||
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10.4285/kjt.2020.34.3.185 doi (DE-627)DOAJ028114698 (DE-599)DOAJ1148c23108584b9f8920794645a30d43 DE-627 ger DE-627 rakwb eng R855-855.5 Jee Won Suh verfasserin aut Impact of extended-criteria donor lungs according to preoperative recipient status and age in lung transplantation 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background : Organ donor shortage remains as one of the limiting factors for lung transplantation. Given the increase in waiting time, preoperative condition has worsened and affects surgical outcomes. This study aimed to evaluate the immediate postoperative and long-term outcomes of lung transplantation in extended-criteria donor (ECD) lungs compared with standard-criteria donor (SCD) lungs. Methods : A total of 246 patients who had undergone double-lung transplantation during the study period were enrolled. SCD was defined based on the following characteristics: age <55 years, <20 pack-years smoking history, and PaO2/fraction of O2 ratio <300 mmHg. Organ donors who do not fulfill these criteria were classified as ECD. Pre- and postoperative data for outcomes and survival data were analyzed. Results : ECD showed significant association with extracorporeal membrane oxygenation weaning in the operating room (hazard ratio [HR], 0.531; 95% confidence interval [CI], 0.291–0.970; P=0.039) considering recipient’s age and status at operation. The ECD group showed comparable survival rate with the SCD group (HR, 1.413; 95% CI, 0.885– 2.255; P=0.148), with adjustment of other factors. However, when the recipient had Korean Network for Organ Sharing (KONOS) status 0 at the time of transplantation (HR, 1.662; 95% CI, 1.025–2.568; P=0.039), G3 primary graft dysfunction at 72 hours after surgery (HR, 2.508; 95% CI, 1.416–4.440; P=0.002) was a risk factor that decreased survival. Conclusions: The outcome of ECD is not inferior to that of SCD. Therefore, ECD lung should be considered a potential donor organ following active donor management rather than a contraindication of transplantation in highly selected recipients. lung transplantation; donor; extended criteria donor Medical technology Jin Gu Lee verfasserin aut Moo Suk Park verfasserin aut Song Yee Kim verfasserin aut Su Jin Jeong verfasserin aut Hyo Chae Paik verfasserin aut In Korean Journal of Transplantation Korean Society for Transplantation, 2019 34(2020), 3, Seite 185-192 (DE-627)1760642282 (DE-600)3072583-5 26718804 nnns volume:34 year:2020 number:3 pages:185-192 https://doi.org/10.4285/kjt.2020.34.3.185 kostenfrei https://doaj.org/article/1148c23108584b9f8920794645a30d43 kostenfrei http://journaleditor.inforang.com/journal/view.html?doi=10.4285/kjt.2020.34.3.185 kostenfrei https://doaj.org/toc/2671-8790 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 34 2020 3 185-192 |
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10.4285/kjt.2020.34.3.185 doi (DE-627)DOAJ028114698 (DE-599)DOAJ1148c23108584b9f8920794645a30d43 DE-627 ger DE-627 rakwb eng R855-855.5 Jee Won Suh verfasserin aut Impact of extended-criteria donor lungs according to preoperative recipient status and age in lung transplantation 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background : Organ donor shortage remains as one of the limiting factors for lung transplantation. Given the increase in waiting time, preoperative condition has worsened and affects surgical outcomes. This study aimed to evaluate the immediate postoperative and long-term outcomes of lung transplantation in extended-criteria donor (ECD) lungs compared with standard-criteria donor (SCD) lungs. Methods : A total of 246 patients who had undergone double-lung transplantation during the study period were enrolled. SCD was defined based on the following characteristics: age <55 years, <20 pack-years smoking history, and PaO2/fraction of O2 ratio <300 mmHg. Organ donors who do not fulfill these criteria were classified as ECD. Pre- and postoperative data for outcomes and survival data were analyzed. Results : ECD showed significant association with extracorporeal membrane oxygenation weaning in the operating room (hazard ratio [HR], 0.531; 95% confidence interval [CI], 0.291–0.970; P=0.039) considering recipient’s age and status at operation. The ECD group showed comparable survival rate with the SCD group (HR, 1.413; 95% CI, 0.885– 2.255; P=0.148), with adjustment of other factors. However, when the recipient had Korean Network for Organ Sharing (KONOS) status 0 at the time of transplantation (HR, 1.662; 95% CI, 1.025–2.568; P=0.039), G3 primary graft dysfunction at 72 hours after surgery (HR, 2.508; 95% CI, 1.416–4.440; P=0.002) was a risk factor that decreased survival. Conclusions: The outcome of ECD is not inferior to that of SCD. Therefore, ECD lung should be considered a potential donor organ following active donor management rather than a contraindication of transplantation in highly selected recipients. lung transplantation; donor; extended criteria donor Medical technology Jin Gu Lee verfasserin aut Moo Suk Park verfasserin aut Song Yee Kim verfasserin aut Su Jin Jeong verfasserin aut Hyo Chae Paik verfasserin aut In Korean Journal of Transplantation Korean Society for Transplantation, 2019 34(2020), 3, Seite 185-192 (DE-627)1760642282 (DE-600)3072583-5 26718804 nnns volume:34 year:2020 number:3 pages:185-192 https://doi.org/10.4285/kjt.2020.34.3.185 kostenfrei https://doaj.org/article/1148c23108584b9f8920794645a30d43 kostenfrei http://journaleditor.inforang.com/journal/view.html?doi=10.4285/kjt.2020.34.3.185 kostenfrei https://doaj.org/toc/2671-8790 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 34 2020 3 185-192 |
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10.4285/kjt.2020.34.3.185 doi (DE-627)DOAJ028114698 (DE-599)DOAJ1148c23108584b9f8920794645a30d43 DE-627 ger DE-627 rakwb eng R855-855.5 Jee Won Suh verfasserin aut Impact of extended-criteria donor lungs according to preoperative recipient status and age in lung transplantation 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background : Organ donor shortage remains as one of the limiting factors for lung transplantation. Given the increase in waiting time, preoperative condition has worsened and affects surgical outcomes. This study aimed to evaluate the immediate postoperative and long-term outcomes of lung transplantation in extended-criteria donor (ECD) lungs compared with standard-criteria donor (SCD) lungs. Methods : A total of 246 patients who had undergone double-lung transplantation during the study period were enrolled. SCD was defined based on the following characteristics: age <55 years, <20 pack-years smoking history, and PaO2/fraction of O2 ratio <300 mmHg. Organ donors who do not fulfill these criteria were classified as ECD. Pre- and postoperative data for outcomes and survival data were analyzed. Results : ECD showed significant association with extracorporeal membrane oxygenation weaning in the operating room (hazard ratio [HR], 0.531; 95% confidence interval [CI], 0.291–0.970; P=0.039) considering recipient’s age and status at operation. The ECD group showed comparable survival rate with the SCD group (HR, 1.413; 95% CI, 0.885– 2.255; P=0.148), with adjustment of other factors. However, when the recipient had Korean Network for Organ Sharing (KONOS) status 0 at the time of transplantation (HR, 1.662; 95% CI, 1.025–2.568; P=0.039), G3 primary graft dysfunction at 72 hours after surgery (HR, 2.508; 95% CI, 1.416–4.440; P=0.002) was a risk factor that decreased survival. Conclusions: The outcome of ECD is not inferior to that of SCD. Therefore, ECD lung should be considered a potential donor organ following active donor management rather than a contraindication of transplantation in highly selected recipients. lung transplantation; donor; extended criteria donor Medical technology Jin Gu Lee verfasserin aut Moo Suk Park verfasserin aut Song Yee Kim verfasserin aut Su Jin Jeong verfasserin aut Hyo Chae Paik verfasserin aut In Korean Journal of Transplantation Korean Society for Transplantation, 2019 34(2020), 3, Seite 185-192 (DE-627)1760642282 (DE-600)3072583-5 26718804 nnns volume:34 year:2020 number:3 pages:185-192 https://doi.org/10.4285/kjt.2020.34.3.185 kostenfrei https://doaj.org/article/1148c23108584b9f8920794645a30d43 kostenfrei http://journaleditor.inforang.com/journal/view.html?doi=10.4285/kjt.2020.34.3.185 kostenfrei https://doaj.org/toc/2671-8790 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 34 2020 3 185-192 |
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10.4285/kjt.2020.34.3.185 doi (DE-627)DOAJ028114698 (DE-599)DOAJ1148c23108584b9f8920794645a30d43 DE-627 ger DE-627 rakwb eng R855-855.5 Jee Won Suh verfasserin aut Impact of extended-criteria donor lungs according to preoperative recipient status and age in lung transplantation 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background : Organ donor shortage remains as one of the limiting factors for lung transplantation. Given the increase in waiting time, preoperative condition has worsened and affects surgical outcomes. This study aimed to evaluate the immediate postoperative and long-term outcomes of lung transplantation in extended-criteria donor (ECD) lungs compared with standard-criteria donor (SCD) lungs. Methods : A total of 246 patients who had undergone double-lung transplantation during the study period were enrolled. SCD was defined based on the following characteristics: age <55 years, <20 pack-years smoking history, and PaO2/fraction of O2 ratio <300 mmHg. Organ donors who do not fulfill these criteria were classified as ECD. Pre- and postoperative data for outcomes and survival data were analyzed. Results : ECD showed significant association with extracorporeal membrane oxygenation weaning in the operating room (hazard ratio [HR], 0.531; 95% confidence interval [CI], 0.291–0.970; P=0.039) considering recipient’s age and status at operation. The ECD group showed comparable survival rate with the SCD group (HR, 1.413; 95% CI, 0.885– 2.255; P=0.148), with adjustment of other factors. However, when the recipient had Korean Network for Organ Sharing (KONOS) status 0 at the time of transplantation (HR, 1.662; 95% CI, 1.025–2.568; P=0.039), G3 primary graft dysfunction at 72 hours after surgery (HR, 2.508; 95% CI, 1.416–4.440; P=0.002) was a risk factor that decreased survival. Conclusions: The outcome of ECD is not inferior to that of SCD. Therefore, ECD lung should be considered a potential donor organ following active donor management rather than a contraindication of transplantation in highly selected recipients. lung transplantation; donor; extended criteria donor Medical technology Jin Gu Lee verfasserin aut Moo Suk Park verfasserin aut Song Yee Kim verfasserin aut Su Jin Jeong verfasserin aut Hyo Chae Paik verfasserin aut In Korean Journal of Transplantation Korean Society for Transplantation, 2019 34(2020), 3, Seite 185-192 (DE-627)1760642282 (DE-600)3072583-5 26718804 nnns volume:34 year:2020 number:3 pages:185-192 https://doi.org/10.4285/kjt.2020.34.3.185 kostenfrei https://doaj.org/article/1148c23108584b9f8920794645a30d43 kostenfrei http://journaleditor.inforang.com/journal/view.html?doi=10.4285/kjt.2020.34.3.185 kostenfrei https://doaj.org/toc/2671-8790 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 34 2020 3 185-192 |
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10.4285/kjt.2020.34.3.185 doi (DE-627)DOAJ028114698 (DE-599)DOAJ1148c23108584b9f8920794645a30d43 DE-627 ger DE-627 rakwb eng R855-855.5 Jee Won Suh verfasserin aut Impact of extended-criteria donor lungs according to preoperative recipient status and age in lung transplantation 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background : Organ donor shortage remains as one of the limiting factors for lung transplantation. Given the increase in waiting time, preoperative condition has worsened and affects surgical outcomes. This study aimed to evaluate the immediate postoperative and long-term outcomes of lung transplantation in extended-criteria donor (ECD) lungs compared with standard-criteria donor (SCD) lungs. Methods : A total of 246 patients who had undergone double-lung transplantation during the study period were enrolled. SCD was defined based on the following characteristics: age <55 years, <20 pack-years smoking history, and PaO2/fraction of O2 ratio <300 mmHg. Organ donors who do not fulfill these criteria were classified as ECD. Pre- and postoperative data for outcomes and survival data were analyzed. Results : ECD showed significant association with extracorporeal membrane oxygenation weaning in the operating room (hazard ratio [HR], 0.531; 95% confidence interval [CI], 0.291–0.970; P=0.039) considering recipient’s age and status at operation. The ECD group showed comparable survival rate with the SCD group (HR, 1.413; 95% CI, 0.885– 2.255; P=0.148), with adjustment of other factors. However, when the recipient had Korean Network for Organ Sharing (KONOS) status 0 at the time of transplantation (HR, 1.662; 95% CI, 1.025–2.568; P=0.039), G3 primary graft dysfunction at 72 hours after surgery (HR, 2.508; 95% CI, 1.416–4.440; P=0.002) was a risk factor that decreased survival. Conclusions: The outcome of ECD is not inferior to that of SCD. Therefore, ECD lung should be considered a potential donor organ following active donor management rather than a contraindication of transplantation in highly selected recipients. lung transplantation; donor; extended criteria donor Medical technology Jin Gu Lee verfasserin aut Moo Suk Park verfasserin aut Song Yee Kim verfasserin aut Su Jin Jeong verfasserin aut Hyo Chae Paik verfasserin aut In Korean Journal of Transplantation Korean Society for Transplantation, 2019 34(2020), 3, Seite 185-192 (DE-627)1760642282 (DE-600)3072583-5 26718804 nnns volume:34 year:2020 number:3 pages:185-192 https://doi.org/10.4285/kjt.2020.34.3.185 kostenfrei https://doaj.org/article/1148c23108584b9f8920794645a30d43 kostenfrei http://journaleditor.inforang.com/journal/view.html?doi=10.4285/kjt.2020.34.3.185 kostenfrei https://doaj.org/toc/2671-8790 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 34 2020 3 185-192 |
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The ECD group showed comparable survival rate with the SCD group (HR, 1.413; 95% CI, 0.885– 2.255; P=0.148), with adjustment of other factors. However, when the recipient had Korean Network for Organ Sharing (KONOS) status 0 at the time of transplantation (HR, 1.662; 95% CI, 1.025–2.568; P=0.039), G3 primary graft dysfunction at 72 hours after surgery (HR, 2.508; 95% CI, 1.416–4.440; P=0.002) was a risk factor that decreased survival. Conclusions: The outcome of ECD is not inferior to that of SCD. 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Impact of extended-criteria donor lungs according to preoperative recipient status and age in lung transplantation |
abstract |
Background : Organ donor shortage remains as one of the limiting factors for lung transplantation. Given the increase in waiting time, preoperative condition has worsened and affects surgical outcomes. This study aimed to evaluate the immediate postoperative and long-term outcomes of lung transplantation in extended-criteria donor (ECD) lungs compared with standard-criteria donor (SCD) lungs. Methods : A total of 246 patients who had undergone double-lung transplantation during the study period were enrolled. SCD was defined based on the following characteristics: age <55 years, <20 pack-years smoking history, and PaO2/fraction of O2 ratio <300 mmHg. Organ donors who do not fulfill these criteria were classified as ECD. Pre- and postoperative data for outcomes and survival data were analyzed. Results : ECD showed significant association with extracorporeal membrane oxygenation weaning in the operating room (hazard ratio [HR], 0.531; 95% confidence interval [CI], 0.291–0.970; P=0.039) considering recipient’s age and status at operation. The ECD group showed comparable survival rate with the SCD group (HR, 1.413; 95% CI, 0.885– 2.255; P=0.148), with adjustment of other factors. However, when the recipient had Korean Network for Organ Sharing (KONOS) status 0 at the time of transplantation (HR, 1.662; 95% CI, 1.025–2.568; P=0.039), G3 primary graft dysfunction at 72 hours after surgery (HR, 2.508; 95% CI, 1.416–4.440; P=0.002) was a risk factor that decreased survival. Conclusions: The outcome of ECD is not inferior to that of SCD. Therefore, ECD lung should be considered a potential donor organ following active donor management rather than a contraindication of transplantation in highly selected recipients. |
abstractGer |
Background : Organ donor shortage remains as one of the limiting factors for lung transplantation. Given the increase in waiting time, preoperative condition has worsened and affects surgical outcomes. This study aimed to evaluate the immediate postoperative and long-term outcomes of lung transplantation in extended-criteria donor (ECD) lungs compared with standard-criteria donor (SCD) lungs. Methods : A total of 246 patients who had undergone double-lung transplantation during the study period were enrolled. SCD was defined based on the following characteristics: age <55 years, <20 pack-years smoking history, and PaO2/fraction of O2 ratio <300 mmHg. Organ donors who do not fulfill these criteria were classified as ECD. Pre- and postoperative data for outcomes and survival data were analyzed. Results : ECD showed significant association with extracorporeal membrane oxygenation weaning in the operating room (hazard ratio [HR], 0.531; 95% confidence interval [CI], 0.291–0.970; P=0.039) considering recipient’s age and status at operation. The ECD group showed comparable survival rate with the SCD group (HR, 1.413; 95% CI, 0.885– 2.255; P=0.148), with adjustment of other factors. However, when the recipient had Korean Network for Organ Sharing (KONOS) status 0 at the time of transplantation (HR, 1.662; 95% CI, 1.025–2.568; P=0.039), G3 primary graft dysfunction at 72 hours after surgery (HR, 2.508; 95% CI, 1.416–4.440; P=0.002) was a risk factor that decreased survival. Conclusions: The outcome of ECD is not inferior to that of SCD. Therefore, ECD lung should be considered a potential donor organ following active donor management rather than a contraindication of transplantation in highly selected recipients. |
abstract_unstemmed |
Background : Organ donor shortage remains as one of the limiting factors for lung transplantation. Given the increase in waiting time, preoperative condition has worsened and affects surgical outcomes. This study aimed to evaluate the immediate postoperative and long-term outcomes of lung transplantation in extended-criteria donor (ECD) lungs compared with standard-criteria donor (SCD) lungs. Methods : A total of 246 patients who had undergone double-lung transplantation during the study period were enrolled. SCD was defined based on the following characteristics: age <55 years, <20 pack-years smoking history, and PaO2/fraction of O2 ratio <300 mmHg. Organ donors who do not fulfill these criteria were classified as ECD. Pre- and postoperative data for outcomes and survival data were analyzed. Results : ECD showed significant association with extracorporeal membrane oxygenation weaning in the operating room (hazard ratio [HR], 0.531; 95% confidence interval [CI], 0.291–0.970; P=0.039) considering recipient’s age and status at operation. The ECD group showed comparable survival rate with the SCD group (HR, 1.413; 95% CI, 0.885– 2.255; P=0.148), with adjustment of other factors. However, when the recipient had Korean Network for Organ Sharing (KONOS) status 0 at the time of transplantation (HR, 1.662; 95% CI, 1.025–2.568; P=0.039), G3 primary graft dysfunction at 72 hours after surgery (HR, 2.508; 95% CI, 1.416–4.440; P=0.002) was a risk factor that decreased survival. Conclusions: The outcome of ECD is not inferior to that of SCD. Therefore, ECD lung should be considered a potential donor organ following active donor management rather than a contraindication of transplantation in highly selected recipients. |
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Impact of extended-criteria donor lungs according to preoperative recipient status and age in lung transplantation |
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https://doi.org/10.4285/kjt.2020.34.3.185 https://doaj.org/article/1148c23108584b9f8920794645a30d43 http://journaleditor.inforang.com/journal/view.html?doi=10.4285/kjt.2020.34.3.185 https://doaj.org/toc/2671-8790 |
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The ECD group showed comparable survival rate with the SCD group (HR, 1.413; 95% CI, 0.885– 2.255; P=0.148), with adjustment of other factors. However, when the recipient had Korean Network for Organ Sharing (KONOS) status 0 at the time of transplantation (HR, 1.662; 95% CI, 1.025–2.568; P=0.039), G3 primary graft dysfunction at 72 hours after surgery (HR, 2.508; 95% CI, 1.416–4.440; P=0.002) was a risk factor that decreased survival. Conclusions: The outcome of ECD is not inferior to that of SCD. Therefore, ECD lung should be considered a potential donor organ following active donor management rather than a contraindication of transplantation in highly selected recipients.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">lung transplantation; donor; extended criteria donor</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Medical technology</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Jin Gu Lee</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Moo Suk Park</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Song Yee Kim</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Su Jin 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