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Bronchial stenosis after lung transplantation from cDCD donors using simultaneous abdominal normothermic regionalp perfusion: a single-center experience

Abstract: Background: Controlled donation after circulatory death (cDCD) has increased the number of lung donors significantly. The use of abdominal normothermic regional perfusion (A-NRP) during organ procurement is a common practice in some centers due to its benefits on abdominal grafts. This study aimed to assess whether the use of A-NRP in cDCD increases the frequency of bronchial stenosis in lung transplant (LT) recipients. Methods: A single-center, retrospective study including all LTs was performed between January 1, 2015, and August 30, 2022. Airway stenosis was defined as a stricture that leads to clinical/functional worsening requiring the use of invasive monitoring and therapeutic procedures. Results: A total of 308 LT recipients were included in the study. Seventy-six LT recipients (24.7%) received lungs from cDCD donors using A-NRP during organ procurement. Forty-seven LT recipients (15.3%) developed airway stenosis, with no differences between lung recipients with grafts from cDCD (17.2%) and donation after brain death donors (13.3%; P = 0.278). A total of 48.9% of recipients showed signs of acute airway ischemia on control bronchoscopy at 2 to 3 wk posttransplant. Acute ischemia was an independent risk factor for airway stenosis development (odds ratio = 2.523 [1.311-4.855], P = 0.006). The median number of bronchoscopies per patient was 5 (2-9), and 25% of patients needed >8 dilatations. Twenty-three patients underwent endobronchial stenting (50.0%) and each patient needed a median of 1 (1-2) stent. Conclusions: Incidence of airway stenosis is not increased in LT recipients with grafts obtained from cDCD donors using A-NRP.

 Fuente: Transplantation, 2023, 107(11), 2415-2423

 Editorial: Lippincott Williams & Wilkins

 Año de publicación: 2023

 Nº de páginas: 9

 Tipo de publicación: Artículo de Revista

 DOI: 10.1097/TP.0000000000004698

 ISSN: 0041-1337,1534-6080

Autoría

VÍCTOR MANUEL MORA CUESTA

TELLO-MENA,SANDRA

IZQUIERDO-CUERVO, SHEILA

DAVID ITURBE FERNANDEZ

SÁNCHEZ-MORENO, LAURA

BALLESTEROS, MARIA ANGELES