A donor PaO2/FiO2 < 300 mm Hg does not determine graft function or survival after lung transplantation
Section snippets
Methods
This study was a single site, prospective trial designed to investigate the relationship between the donor and recipient P/F ratios at various time points during and following lung transplantation and the effect on long-term outcomes. Donor lungs that were accepted for transplantation between November 17, 2014 and January 28, 2017 were included in the study. The donor assessment was conducted according to standard Australian processes. This study was approved by the Alfred Human Research Ethics
Donor characteristics
There were 93 donors (mean age 41.7 ± 16.6 years, 54.8% male, 53.8% smoking history) and 93 recipients (mean age 55.6 ± 13.2 years, 60.2% male) included in the study. Donor, intraoperative, and recipient clinical characteristics are displayed in Table 1. Median donor ventilation duration was 64 hours (IQR 36-92), and the mean time to procurement from donor death was 23.0 ± 11.3 hours.
Donor P/F ratio
Of the 93 donor lungs, 81 (87.1%) had a P/F ratio of ≥ 300, and 12 (12.9%) had a P/F ratio of < 300 in the ICU
Discussion
The key point of this study is that in carefully selected cases, the donor P/F ratio threshold of 300 for acceptability for transplantation can be transgressed without deleterious impact on survival within the first year after transplantation. In addition, the time to extubation, incidence of PGD, and pulmonary function at 6 and 12 months is not influenced by this single measure. What this study does not reveal is the lowest P/F ratio from the arterial line in the ICU that would be consistent
Disclosure statement
The authors have no conflicts of interest to disclose.
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These authors contributed equally to this work.