The Journal of Thoracic and Cardiovascular Surgery
Thoracic: Lung TransplantationOutcomes of lung transplantation at a Canadian center using donors declined in the United States
Graphical abstract
Section snippets
Study Design
We performed a single-center retrospective review of recipients receiving lung transplantation between January 2009 and October 2019 at Toronto Lung Transplant Program. This study was approved by our institutional research ethics board (No. 17-5280) for a retrospective review of data prospectively collected in our database. We divided the analysis into 2 groups: recipients receiving donor lungs from Canada or the United States. Donor and recipient characteristics between the 2 groups were
Donor Characteristics
During the study period, 1424 lung transplants were performed at our center. Of these, 124 (8.7%) were performed using donors from the United States. The number of lung transplants per year using US donors is shown in Figure 1, A. The incidence of transplants using US donors increased from 5% (5 out of 102) in 2009 to 15% (30 out of 200) in 2018 (Figure 1, B). Twenty-one OPOs in the United States offered lungs to our center during the study period. Before donor lungs were offered to our center,
Discussion
In this report, we demonstrate that transplantation of donor lungs that were declined in the United States and offered to Canada can provide excellent outcomes that are similar to primary offers to our center from Canadian donors. US donors were younger, less likely to be DCD donors, and more commonly tested positive for HCV. We believe the availability of a high-performance EVLP program at our center stimulated American OPOs to send offers more liberally to our program. Yet, this technology
Conclusions
Lung transplantation using donor lungs declined by multiple centers in the United States, resulting in similar short- and long-term outcomes compared with donor lungs offered in Canada. We believe this work may stimulate US lung transplant centers to further evaluate the current pool of declined donor lungs in the United States.
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Cited by (10)
The Past, Present, and Near Future of Lung Allocation in the United States
2023, Clinics in Chest MedicineTwenty-Five Years of Lung Transplantation in Medellín: Overcoming the Challenges of an Emerging Country
2023, Seminars in Thoracic and Cardiovascular SurgeryOutcomes of lung transplantation from donors with a history of substance abuse
2023, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :Offers are also received from the other 5 Canadian provinces after being turned down by their corresponding lung transplant programs. Also, we receive offers of lungs from the United States that were turned down by local programs.15 All information about donor cigarette, marijuana smoking, and OU is gathered from interviews conducted by local donor coordinators with donor family members.
Commentary: A sobering reality: Donor lungs declined in the United States transplanted successfully in Canada
2022, Journal of Thoracic and Cardiovascular SurgeryCommentary: Lungs across borders: American lungs in Canadian patients
2022, Journal of Thoracic and Cardiovascular Surgery
This study was funded by internal department funding sources.