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 Using fragment-based approaches to discover new antibiotics
21.06.2018 | SLAS (Society for Laboratory Automation and Screening)

nachricht Scientists learn more about how gene linked to autism affects brain
19.06.2018 | Cincinnati Children's Hospital 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: Temperature-controlled fiber-optic light source with liquid core

In a recent publication in the renowned journal Optica, scientists of Leibniz-Institute of Photonic Technology (Leibniz IPHT) in Jena showed that they can accurately control the optical properties of liquid-core fiber lasers and therefore their spectral band width by temperature and pressure tuning.

Already last year, the researchers provided experimental proof of a new dynamic of hybrid solitons– temporally and spectrally stationary light waves resulting...

Im Focus: Overdosing on Calcium

Nano crystals impact stem cell fate during bone formation

Scientists from the University of Freiburg and the University of Basel identified a master regulator for bone regeneration. Prasad Shastri, Professor of...

Im Focus: AchemAsia 2019 will take place in Shanghai

Moving into its fourth decade, AchemAsia is setting out for new horizons: The International Expo and Innovation Forum for Sustainable Chemical Production will take place from 21-23 May 2019 in Shanghai, China. With an updated event profile, the eleventh edition focusses on topics that are especially relevant for the Chinese process industry, putting a strong emphasis on sustainability and innovation.

Founded in 1989 as a spin-off of ACHEMA to cater to the needs of China’s then developing industry, AchemAsia has since grown into a platform where the latest...

Im Focus: First real-time test of Li-Fi utilization for the industrial Internet of Things

The BMBF-funded OWICELLS project was successfully completed with a final presentation at the BMW plant in Munich. The presentation demonstrated a Li-Fi communication with a mobile robot, while the robot carried out usual production processes (welding, moving and testing parts) in a 5x5m² production cell. The robust, optical wireless transmission is based on spatial diversity; in other words, data is sent and received simultaneously by several LEDs and several photodiodes. The system can transmit data at more than 100 Mbit/s and five milliseconds latency.

Modern production technologies in the automobile industry must become more flexible in order to fulfil individual customer requirements.

Im Focus: Sharp images with flexible fibers

An international team of scientists has discovered a new way to transfer image information through multimodal fibers with almost no distortion - even if the fiber is bent. The results of the study, to which scientist from the Leibniz-Institute of Photonic Technology Jena (Leibniz IPHT) contributed, were published on 6thJune in the highly-cited journal Physical Review Letters.

Endoscopes allow doctors to see into a patient’s body like through a keyhole. Typically, the images are transmitted via a bundle of several hundreds of optical...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Munich conference on asteroid detection, tracking and defense

13.06.2018 | Event News

2nd International Baltic Earth Conference in Denmark: “The Baltic Sea region in Transition”

08.06.2018 | Event News

ISEKI_Food 2018: Conference with Holistic View of Food Production

05.06.2018 | Event News

 
Latest News

Graphene assembled film shows higher thermal conductivity than graphite film

22.06.2018 | Materials Sciences

Fast rising bedrock below West Antarctica reveals an extremely fluid Earth mantle

22.06.2018 | Earth Sciences

Zebrafish's near 360 degree UV-vision knocks stripes off Google Street View

22.06.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>