Use of Organ Care System (OCS) Lung in Donation After Circulatory Death (DCD) and Donation After Brain Death (DBD) Lung Transplants
Recommended Citation
Loor G, Fernandez R, Patel K, Belli E, Lee A, Smith M, Salerno C, Song T, Siddique A, Langer N, Kukreja J, Nemeh H, Hartwig M, Daneshm M, Chan J, Schwartz G, Toyoda Y, Durham L, Ardehali A, Bush E, Suarez E, Hertz M, Garcha P, Huddleston S. Use of Organ Care System (OCS) Lung in Donation After Circulatory Death (DCD) and Donation After Brain Death (DBD) Lung Transplants. J Heart Lung Transplant 2025; 44(4):S513-S514.
Document Type
Conference Proceeding
Publication Date
4-1-2025
Publication Title
J Heart Lung Transplant
Abstract
Purpose: DCD is an important and underutilized source of donor lungs for transplant. The current study analyzes a large contemporary prospective registry comparing post-lung transplant outcomes associated with DCD versus DBD donors preserved with OCS Lung. Methods: The Thoracic Organ Perfusion (TOP) registry collects prospective data from consented individuals transplanted with donor lungs preserved using the OCS Lung, a portable cellular ex vivo lung perfusion platform. We compared post-transplant primary graft dysfunction grade 3 (PGD3) and survival outcomes in patients transplanted with OCS-DCD versus OCS-DBD donors. Results: This study included 111 (24%) OCS-DCD lung transplants and 347 (76%) OCS-DBD lung transplants from the TOP registry. Out of all donors, 17.5% were >55 years of age, 8.5% had a PaO2:FiO2 ratio < 300 prior to retrieval, and 8.5% had a significant smoking history. Mean cross clamp time was 641 min. Except for abnormal findings on physical examination prior to retrieval, which were more common in the OCS-DBD group (60.5% vs 47.8%, p=0.021), there were no differences in donor characteristics or cross clamp times between OCS-DCD and OCS-DBD groups. Recipients in the OCS-DCD group were older (60 vs 57 years, p=0.024), less likely to be on ECMO (5.4% vs 13%, p=0.03), and less likely to have a history of prior solid organ transplant (1.8% vs 7.5%) compared to OCS-DBD. The average final PaO2:FiO2 ratio on OCS perfusion was 431 in the OCS-DCD group and 428 in the OCS-DBD group (p=0.778). The incidence of PGD3 within 72 hours (inclusive of 6 hrs post-reperfusion) was 64% in the OCS-DCD group and 53.8% in the OCS-DBD group (p=0.06). The incidence of PGD3 at 72 hours was 31.5% in the OCS-DCD group and 24.1% in the OCS-DBD group (p=0.13). Survival was similar between the two groups (p=0.38). Conclusion: In the current analysis of a large prospective registry of OCS Lung transplants, there were no significant differences in PGD3 or survival noted between DCD and DBD. [Formula presented]
Volume
44
Issue
4
First Page
S513
Last Page
S514
