Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Surgery Today
Published in: Surgery Today 10/2018

01-10-2018 | Original Article

Low-risk donor lungs optimize the post-lung transplant outcome for high lung allocation score patients

Authors: Takeshi Kurosaki, Kentaroh Miyoshi, Shinji Otani, Kentaro Imanishi, Seiichiro Sugimoto, Masaomi Yamane, Motomu Kobayashi, Shinichi Toyooka, Takahiro Oto

Published in: Surgery Today | Issue 10/2018

Login to get access

Abstract

Purpose

The lung allocation score (LAS) has been generally recognized as a contributor to the overall survival in lung transplant candidates. However, donor-related risks have never been taken into consideration in previous research that validated the LAS. This study aimed to determine whether or not the role of the LAS as a predictor of the posttransplant outcome is influenced by the quality of the donor lungs.

Methods

We retrospectively reviewed 108 patients who underwent lung transplantation at Okayama University Hospital since 1998. The cohort was divided into two groups based on the lung donor score (DS; ≤ 4/> 4). Correlations between the LAS and posttransplant outcomes were investigated in both groups.

Results

In the high-DS group, an elevated LAS was strongly associated with posttransplant PaO2/FiO2 (p = 0.018). However, in the low-DS group, no correlation was found between them. There was no significant difference in the long-term survival according to the LAS in the low-DS group. The LAS effectively predicted the posttransplant outcome only when lungs with DS > 4 were transplanted; the LAS was not reliable if high-quality lungs were transplanted.

Conclusion

Lung transplantation can be feasible and provides a survival benefit even for high-LAS patients if lungs from a low-risk donor are transplanted.
Literature
1.
2.
Egan TM, Murray S, Bustami RT, Shearon TH, McCullough KP, Edwards LB, et al. Development of the new lung allocation system in the United States. Am J Transplant. 2006;6(5 Pt 2):1212–27.CrossRefPubMed
3.
Kozower BD, Meyers BF, Smith MA, De Oliveira NC, Cassivi SD, Guthrie TJ, et al. The impact of the lung allocation score on short-term transplantation outcomes: a multicenter study. J Thorac Cardiovasc Surg. 2008;135(1):166–71.CrossRefPubMed
4.
Liu V, Zamora MR, Dhillon GS, Weill D. Increasing lung allocation scores predict worsened survival among lung transplant recipients. Am J Transplant. 2010;10(4):915–20.CrossRefPubMedPubMedCentral
5.
Russo MJ, Iribarne A, Hong KN, Davies RR, Xydas S, Takayama H, et al. High lung allocation score is associated with increased morbidity and mortality following transplantation. Chest. 2010;137(3):651–7.CrossRefPubMed
6.
Horai T, Shigemura N, Gries C, Pilewski J, Bhama JK, Bermudez CA, et al. Lung transplantation for patients with high lung allocation score: single-center experience. Ann Thorac Surg. 2012;93(5):1592–7 (discussion 7).CrossRefPubMed
7.
8.
Mulligan MJ, Sanchez PG, Evans CF, Wang Y, Kon ZN, Rajagopal K, et al. The use of extended criteria donors decreases one-year survival in high-risk lung recipients: a review of the United Network of Organ Sharing Database. J Thorac Cardiovasc Surg. 2016;152(3):891–8.e2.CrossRef
9.
Moreno P, Alvarez A, Santos F, Vaquero JM, Baamonde C, Redel J, et al. Extended recipients but not extended donors are associated with poor outcomes following lung transplantation. Eur J Cardiothorac Surg. 2014;45(6):1040–7.CrossRefPubMed
10.
Sommer W, Kuhn C, Tudorache I, Avsar M, Gottlieb J, Boethig D, et al. Extended criteria donor lungs and clinical outcome: results of an alternative allocation algorithm. J Heart Lung Transplant. 2013;32(11):1065–72.CrossRefPubMed
11.
Oto T, Levvey BJ, Whitford H, Griffiths AP, Kotsimbos T, Williams TJ, et al. Feasibility and utility of a lung donor score: correlation with early post-transplant outcomes. Ann Thorac Surg. 2007;83(1):257–63.CrossRefPubMed
12.
Porro GA, Valenza F, Coppola S, Froio S, Benazzi E, De Fazio N, et al. Use of the Oto lung donor score to analyze the 2010 donor pool of the Nord Italia Transplant program. Transplant Proc. 2012;44(7):1830–4.CrossRefPubMed
13.
Smits JM, van der Bij W, Van Raemdonck D, de Vries E, Rahmel A, Laufer G, et al. Defining an extended criteria donor lung: an empirical approach based on the Eurotransplant experience. Transpl Int. 2011;24(4):393–400.CrossRefPubMed
14.
Cypel M, Yeung JC, Liu M, Anraku M, Chen F, Karolak W, et al. Normothermic ex vivo lung perfusion in clinical lung transplantation. N Engl J Med. 2011;364(15):1431–40.CrossRefPubMed
15.
Israni AK, Zaun D, Bolch C, Rosendale J, Snyder JJ, Kasiske BL. OPTN/SRTR annual data report 2014, deceases organ donation. Am J Transplant. 2016;16:195–215.CrossRefPubMed
16.
Hoshikawa Y, Okada Y, Ashikari J, Matsuda Y, Niikawa H, Noda M, et al. Medical consultant system for improving lung transplantation opportunities and outcomes in Japan. Transplant Proc. 2015;47(3):746–50.CrossRef
17.
Eurotransplant International, Foundation. Eurotransplant: donation, waiting lists and transplants. In: Branger P, Samuel U, editors. Annual report 2016 of the Eurotransplant international foundation. 2016. pp 43–66.
18.
Hayes D, Tobias JD, Tumin D. Center volume and extracorporeal membrane oxygenation support at lung transplantation in the lung allocation score era. Am J Respir Crit Care Med. 2016;194(3):317–26.CrossRefPubMed
19.
Hayanga JW, Lira A, Aboagye JK, Hayanga HK, D’Cunha J. Extracorporeal membrane oxygenation as a bridge to lung transplantation: what lessons might we learn from volume and expertise? Interact Cardiovasc Thorac Surg. 2016;22(4):406–10.CrossRefPubMed
20.
Toyoda Y, Bhama JK, Shigemura N, Zaldonis D, Pilewski J, Crespo M, et al. Efficacy of extracorporeal membrane oxygenation as a bridge to lung transplantation. J Thorac Cardiovasc Surg. 2013;145(4):1065–70 (discussion 70–1).CrossRefPubMed
21.
Black MC, Trivedi J, Schumer EM, Bousamra M II, van Berkel V. Double lung transplants have significantly improved survival compared with single lung transplants in high lung allocation score patients. Ann Thorac Surg. 2014;98(5):1737–41.CrossRefPubMed
22.
Sato M, Okada Y, Oto T, Minami M, Shiraishi T, Nagayasu T, et al. Registry of the Japanese Society of Lung and Heart–Lung Transplantation: official Japanese lung transplantation report, 2014. Gen Thorac Cardiovasc Surg. 2014;62(10):594–601.CrossRefPubMed
23.
Soyama A, Eguchi S. The current status and future perspectives of organ donation in Japan: learning from the systems in other countries. Surg Today. 2016;46(4):387–92.CrossRefPubMed
24.
Nakagiri T, Inoue M, Minami M, Hoshikawa Y, Chida M, Bando T, et al. Interim report of the Japanese original donor evaluation and management system: the medical consultant system. Surg Today. 2014;44(7):1227–31.CrossRefPubMed
25.
Somers J, Ruttens D, Verleden SE, Cox B, Stanzi A, Vandermeulen E, et al. A decade of extended-criteria lung donors in a single center: was it justified? Transpl Int. 2015;28(2):170–9.CrossRefPubMed
Metadata
Title
Low-risk donor lungs optimize the post-lung transplant outcome for high lung allocation score patients
Authors
Takeshi Kurosaki
Kentaroh Miyoshi
Shinji Otani
Kentaro Imanishi
Seiichiro Sugimoto
Masaomi Yamane
Motomu Kobayashi
Shinichi Toyooka
Takahiro Oto
Publication date
01-10-2018
Publisher
Springer Singapore
Published in
Surgery Today / Issue 10/2018
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-018-1670-7

Other articles of this Issue 10/2018

Surgery Today 10/2018 Go to the issue

Letter to the Editor

Is chronological age really not a contraindication to gastrectomy for very elderly patients?

Original Article

Classification of remnant stomach shape after distal gastrectomy with Billroth-I reconstruction and a comparison of the postoperative outcomes

Original Article

Lymph nodes around the posterior gastric artery: their existence, frequency, and clinical implications

Short Communication

Validating margin status in lung wedge resection for clinical stage I non-small cell lung cancer

Correction

Correction to: Single lung transplantation for lymphangioleiomyomatosis: a single-center experience in Japan

Original Article

Single lung transplantation for lymphangioleiomyomatosis: a single-center experience in Japan