Donation After Circulatory Death in lung transplantation

Abstract

The continuing shortage of pulmonary grafts from donors after brain death has led to a resurgence of interest in lung transplantation from donors after circulatory death (DCD). Most lungs from donors after withdrawal from life-sustaining therapy can be recovered rapidly and transplanted directly without ex-vivo assessment in case functional warm ischemic time is limited to 30 to 60 min. The potential of the DCD lung pool is still underutilized and should be maximized in countries with existing legislation. Countries lacking a DCD pathway should be encouraged to develop national ethical, professional, and legal frameworks to address public and professional concerns.

Keywords: Donation after brain death; Donation after circulatory death; End-of-life care; Lung transplantation; Normothermic regional perfusion; Primary graft dysfunction; Withdrawal from life-sustaining therapy.