Jose Luis Campo-Cañaveral de la Cruz

Objective: To determine the impact of prolonged storage of donor lungs at 10 °C for up to 24 hours on outcome after lung transplantation. Background: An increasing body of evidence suggests 10 °C as the optimal storage temperature for donor lungs. A recent study showed that cold ischemic times can be safely expanded to >12 hours when lungs are stored at 10 °C. However, it is currently unknown how long donor lungs can be preserved before they deteriorate in function. Methods: Patients who received a donor lung stored at 10 °C between November 2020 and June 2023 at the lung transplant programs of Toronto, Vienna, and Madrid were included in this retrospective analysis. After excluding ex-vivo lung perfusion cases, recipients were grouped based on the total preservation times of their donor organs (P = 0.493]. Intensive care unit length of stay [6 days (4–14); 8 days (4–23); 8 days (5–32)] and hospital length of stay [32 days (20–48); 29 days (20–50); 26 days (17–50)] were also similar. Furthermore, the length of donor organ preservation had no impact on patient survival (log-rank P = 0.413). Conclusions: Prolonged static preservation of donor lungs at 10 °C for up to 24 hours is safe and does not impair short-intermediate outcomes after lung transplantation.

OBJECTIVES: The aim of this study was to compare the outcomes of lung transplantations using grafts from donors aged over 70 years against those performed using younger donors. METHODS: This retrospective single-centre analysis includes lung transplants conducted at our institution from January 2014 to June 2022. Lung recipients were classified into 2 groups based on donor age (group A <70 years; group B ≥70 years). Variables regarding demographics, peri and postoperative outcomes and survival were included. The statistical analysis approach included univariable analysis, propensity score matching to address imbalances in donor variables (smoking status), recipient characteristics (sex, age, diagnosis and lung allocation score) and calendar period and survival analysis. RESULTS: A total of 353 lung transplants were performed in this period, 47 (13.3%) using grafts from donors aged over 70 years. Donors in group B were more frequently women (70.2% vs 51.6%, P = 0.017), with less smoking history (22% vs 43%, P = 0.002) and longer mechanical ventilation time (3 vs 2 days, P = 0.025). Recipients in group B had a higher lung allocation score (37.5 vs 35, P = 0.035). Postoperative variables were comparable between both groups, except for pulmonary function tests. Group B demonstrated lower forced expiratory volume 1 s levels (2070 vs 2580 ml, P = 0.001). The propensity score matching showed a lower chance of chronic lung allograft dysfunction by 12% for group B. One-, three- and five-year survival was equal between the groups. CONCLUSIONS: The use of selected expanded-criteria donors aged over 70 years did not result in increased postoperative morbidity, early mortality or survival in this study.