Transplant Outcomes Similar With Lungs From 'Increased-Risk' Donors

Using lungs for transplant from donors who are considered at high risk for certain infectious diseases has similar one-year outcomes for recipients compared with using lungs from standard-risk donors, according to a study recently published in the Journal of Thoracic and Cardiovascular Surgery.

Carli J. Lehr, M.D., from the Cleveland Clinic, and colleagues studied the impact of the U.S. Public Health Service broadened definition of increased-risk donors (IRD; January 2014 through May 2017) versus high-risk donors (HRD; January 2006 to October 2013) and donors at standard infectious risk on lung transplant recipient outcomes.

The researchers identified 18,490 lung transplant recipients, 36 percent of whom received lungs during the IRD definition period. With the definition change, the proportion of donors classified as having nonstandard infectious risk increased (8 percent HRD versus 22 percent IRD; P < 0.001). Within both periods, graft and patient survival were similar for both donor types. Additionally, acute treated rejection within one year was similar for recipients of IRD (odds ratio, 0.87; P = 0.23) and recipients of HRD (odds ratio, 1.2; P = 0.27).

"Our findings raise the question of the utility of the designation of 'increased risk' for donor lungs, since there is no impact on outcomes," Lehr said in a statement. "Forgoing the designation, treating all donors as potentially at risk, and using appropriate posttransplant screening for infectious diseases may increase overall organ utilization and lessen deaths on the waitlist."

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