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You are here: Back issues » acp-2011 » acp-1-2011 » 05_vanraemdonck

Initial experience with transplantation of lungs recovered from donors after euthanasia

D. Van Raemdonck, G. M. Verleden, L. Dupont,  D. Ysebaert, D. Monbaliu, A. Neyrinck, W. Coosemans, H. Decaluwe, P. De Leyn, P. Nafteux, T. Lerut
[Applied Cardiopulmonary Pathophysiology 15: 38-48, 2011]


Objectives: Donors after cardiac death (DCD) have increasingly provided organs for lung transplantation (LTx). The use of lungs from donors after euthanasia has not yet been reported.
Methods: Between 01/2007-12/2009, 17/145 (11.7%) isolated LTx were performed from controlled DCD, including 4 (2.8%) after euthanasia. All donors expressed their wish for organ donation once their request for euthanasia was granted according to Belgian legislation. All donors suffered from an unbearable non-malignant disorder.
Results: The warm ischemic time between circulatory arrest and cold flush of donor lungs was 14 [10-16] min. Total ischemic time until reperfusion of the graft was 329 [225-414] min for the first lung and 517 [346-547] min for the second lung. No severe graft dysfunction was observed beyond 24 hours. One recipient died in the ICU from a problem unrelated to the graft. The remaining patients were extubated after 2 [2-3] days and discharged from ICU after 7 [4-7] days and from hospital after 33 [23-36] days. FEV1 and FVC increased from 16 [15-21]% and 52 [51-59]% pre-transplant to 85 [61-94]% and 79 [63-84]% at the time of hospital discharge, respectively; (p<0.01). Actuarial 1-year and 3-year survival was 75%.
Conclusion: Euthanasia donors accounted for 23.5% of all DCD lung donors with excellent post-transplant graft function and good early recipient outcome.

Key words:  lung transplantation, donation after cardiac death, donation after brain death, non-heart-beating donors, euthanasia, end-of-life

Correspondence address:
Prof. Dirk Van Raemdonck
Department of Thoracic Surgery
University Hospital Gasthuisberg
Herestraat 49
3000 Leuven
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