• Clinics · Jan 2023

    Extended criteria donor organ use for heart-lung transplantation in the modern era.

    • Noah Weingarten, Amit Iyengar, David Alan Herbst, Mark Helmers, Danika Meldrum, Sara Guevara-Plunkett, Jessica Dominic, and Pavan Atluri.
    • Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, USA.
    • Clinics (Sao Paulo). 2023 Jan 1; 78: 100205100205.

    BackgroundDemand for donor hearts and lungs exceeds their supply. Extended Criteria Donor (ECD) organs are used to help meet this demand, but their impact on heart-lung transplantation outcomes is poorly characterized.Methods And ResultsThe United Network for Organ Sharing was queried for data on adult heart-lung transplantation recipients (n = 447) from 2005‒2021. Recipients were stratified based on whether they received ECD hearts and/or lungs. Morbidity was analyzed using Kruskal-Wallis, chi-square, and Fisher's exact tests. Mortality was analyzed using Kaplan-Meier estimation, log-rank tests and Cox regression. Sixty-five (14.5%) patients received two ECD organs, 134 (30.0%) received only an ECD lung, and 65 (14.5%) only an ECD heart. Recipients of two ECD organs were older, more likely to have diabetes, and more likely transplanted from 2015‒2021 (p < 0.05). Groups did not differ by pre-transplant diagnosis, intensive care unit disposition, life support use, or hemodynamics. Group five-year survival rates ranged from 54.5% to 63.2% (p = 0.428). Groups did not differ by 30-day mortality, strokes, graft rejection, or hospital length of stay.ConclusionsUsing ECD hearts and/or lungs for heart-lung transplantation is not associated with increased mortality and is a safe strategy for increasing donor organ supply in this complex patient population.Copyright © 2023 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.

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