PURPOSE: To review outcomes of lung transplant recipients who received lungs from donors with a history of high risk social behavior (HRSB).
METHODS: We conducted a retrospective chart review of lung transplant recipients from 1998 to 2003. Donor charts provided demographics, cause of death, and social history. Recipient charts provided demographics, pulmonary function tests (PFT) prior to discharge and at follow-up as well as outcomes. Univariate analysis was performed to determine differences between recipients of HRSB lungs and non-HRSB lungs.
RESULTS: Among 211 lung transplantation patients (83 double, 128 single), 82 (39%) patients received lungs from donors with HRSB. Donors with HRSB were more likely to be male (57% vs. 42%, p<0.0001) compared to controls. In addition, head trauma was the most common cause of death (40%) for HRSB donors whereas controls mostly died from intracranial hemorrhages (41%). There was no significant difference in PaO2/FiO2 (4.20 vs. 4.26, p=0.70) between HRSB donors and controls at the time of donation. There were no differences in lengths of stay following transplantation. However, compared to controls, HRSB recipients had better FVC and FEV1 prior to discharge (2.24 vs. 1.88, p<0.0001 and 1.66 vs. 1.39, p<0.001) and at follow-up (2.68 vs. 2.31, p<0.01 and 1.67 vs. 1.55, p=0.25). 30-day survival was excellent for both groups at 98% and 1-year survival was 85% for HRSB recipients and 82% for controls (p=0.53). There were no differences in overall survival at follow-up with HRSB recipients at 49% at 3.76 years and 48% at 4.21 years for controls (p=0.98).
CONCLUSION: HRSB grafts have better PFT prior to discharge and at follow-up however this does not translate into a difference in survival. HRSB donors can provide acceptable organs for lung transplantation and their usage can help expand the donor pool.
CLINICAL IMPLICATIONS: Utilizing donors with a history of high risk social history ensures that viable organs are utilized to their fullest life saving potential.
DISCLOSURE: Nikolai Sopko, No Financial Disclosure Information; No Product/Research Disclosure Information