Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Modified lung donor standards decrease mortality

29.10.2003


’Extended’ criteria increase organ donations without compromising patient health



Using more liberal criteria to evaluate potential lung donors combined with aggressive donor management significantly increases the availability of potential lung donors, and ultimately decreases mortality of recipients on the waiting list, says a new study presented at CHEST 2003, the 69th annual international scientific assembly of the American College of Chest Physicians (ACCP). The new study introduces the concept of physician-directed protocol (PDP), which incorporates the evaluation and management of every possible lung donor using more liberal or "extended" donor criteria and intensive education of pulmonologists and staff of the Organ Procurement Organization (OPO) in evaluating and managing donors with a set protocol. The study shows that with the use of this protocol, the number of lung donations increased by 119 percent and mean waiting time decreased by 70 percent. A related study also found that the use of lungs obtained from extended donors did not compromise the health of the organ recipient.

"The number of patients on the waiting list for lung transplants has continued to increase over the last several years, yet the number of donor lungs remains relatively stable. Therefore, the waiting time for a lung transplant has increased as has the number of patients who die while waiting for a transplant," said lead author Deborah Levine, MD, Assistant Professor in Medicine and Thoracic Surgery, University of Texas Health Science Center, San Antonio, TX. "A shortage of donor lungs is the primary limitation in increasing lung transplantation. With intensive education of the OPO’s, we are now being called on every potential donor lung and evaluating them for the possibility of transplant."


Researchers from the University of Texas Health Science Center and Texas Organ Sharing Alliance evaluated the effect of the new PDP on the number of donors, lung transplants performed, waiting list time, and clinical outcomes. Researchers reviewed the charts of all potential lung donors for 18 months prior to and following the establishment of the PDP. After the PDP was initiated, the number of lung donations increased from 17 to 39, showing an increase of 119 percent. The number of lung transplants also increased from 30 to 64, and the mean waiting time on the transplant list decreased from 290 days to 87 days.

In a related study from the University of Texas Health Science Center, researchers evaluated the clinical outcomes of lung transplants in patients receiving either extended or standard donor lungs. Donors were considered "extended" if they met any of the following criteria: donor age of 55 or older, smoking history of more than 20 pack-years, having a history of pulmonary disease, chest radiographic changes, purulent sputum on bronchoscopy, or a decrease in oxygenation on 100 percent oxygen. Donors were matched with recipients, resulting in 20 patients receiving extended donor lungs and 11 patients receiving standard lungs. Recipients in both donor groups had similar outcomes in all posttransplant evaluation categories, including hospital and intensive care unit length of stay, length of intubation, readmission to the hospital, 6- and 12-month lung function tests, and 30-day mortality.

"Most of the donors whose lungs we are now transplanting have met at least one of the criteria for extended donors, which would have made them an ineligible donor in the past. By using the physician-directed protocol, working closely with the Texas Organ Sharing Alliance, and extending the criteria for lung donation, we have been able to significantly decrease a recipient’s waiting time on the transplant list, without compromising recipient outcome," said Dr. Levine.

"The lack of organ donors is an ongoing concern in the United States and around the world. For patients in the end-stage of lung disease, lung transplants can greatly improve quality of life and even survival. With more than 25 million Americans now living with chronic lung disease, it is essential that we exhaust every possibility to increase lung donations," said Richard S. Irwin, MD, FCCP, President of the American College of Chest Physicians.


CHEST 2003 is the 69th annual international scientific assembly of the American College of Chest Physicians, being held in Orlando, October 25-30. ACCP represents more than 15,700 members who provide clinical respiratory, critical care, and cardiothoracic patient care in the United States and throughout the world. ACCP’s mission is to promote the prevention and treatment of diseases of the chest through leadership, education, research, and communication.

Arielle Green | EurekAlert!
Further information:
http://www.chestnet.org/

More articles from Health and Medicine:

nachricht GLUT5 fluorescent probe fingerprints cancer cells
20.04.2018 | Michigan Technological University

nachricht Scientists re-create brain neurons to study obesity and personalize treatment
20.04.2018 | Cedars-Sinai Medical Center

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: BAM@Hannover Messe: innovative 3D printing method for space flight

At the Hannover Messe 2018, the Bundesanstalt für Materialforschung und-prüfung (BAM) will show how, in the future, astronauts could produce their own tools or spare parts in zero gravity using 3D printing. This will reduce, weight and transport costs for space missions. Visitors can experience the innovative additive manufacturing process live at the fair.

Powder-based additive manufacturing in zero gravity is the name of the project in which a component is produced by applying metallic powder layers and then...

Im Focus: Molecules Brilliantly Illuminated

Physicists at the Laboratory for Attosecond Physics, which is jointly run by Ludwig-Maximilians-Universität and the Max Planck Institute of Quantum Optics, have developed a high-power laser system that generates ultrashort pulses of light covering a large share of the mid-infrared spectrum. The researchers envisage a wide range of applications for the technology – in the early diagnosis of cancer, for instance.

Molecules are the building blocks of life. Like all other organisms, we are made of them. They control our biorhythm, and they can also reflect our state of...

Im Focus: Spider silk key to new bone-fixing composite

University of Connecticut researchers have created a biodegradable composite made of silk fibers that can be used to repair broken load-bearing bones without the complications sometimes presented by other materials.

Repairing major load-bearing bones such as those in the leg can be a long and uncomfortable process.

Im Focus: Writing and deleting magnets with lasers

Study published in the journal ACS Applied Materials & Interfaces is the outcome of an international effort that included teams from Dresden and Berlin in Germany, and the US.

Scientists at the Helmholtz-Zentrum Dresden-Rossendorf (HZDR) together with colleagues from the Helmholtz-Zentrum Berlin (HZB) and the University of Virginia...

Im Focus: Gamma-ray flashes from plasma filaments

Novel highly efficient and brilliant gamma-ray source: Based on model calculations, physicists of the Max PIanck Institute for Nuclear Physics in Heidelberg propose a novel method for an efficient high-brilliance gamma-ray source. A giant collimated gamma-ray pulse is generated from the interaction of a dense ultra-relativistic electron beam with a thin solid conductor. Energetic gamma-rays are copiously produced as the electron beam splits into filaments while propagating across the conductor. The resulting gamma-ray energy and flux enable novel experiments in nuclear and fundamental physics.

The typical wavelength of light interacting with an object of the microcosm scales with the size of this object. For atoms, this ranges from visible light to...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Invitation to the upcoming "Current Topics in Bioinformatics: Big Data in Genomics and Medicine"

13.04.2018 | Event News

Unique scope of UV LED technologies and applications presented in Berlin: ICULTA-2018

12.04.2018 | Event News

IWOLIA: A conference bringing together German Industrie 4.0 and French Industrie du Futur

09.04.2018 | Event News

 
Latest News

Quantum Technology for Advanced Imaging – QUILT

24.04.2018 | Information Technology

AWI researchers measure a record concentration of microplastic in arctic sea ice

24.04.2018 | Earth Sciences

Complete skin regeneration system of fish unraveled

24.04.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>