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Upgrading Donor Lung Quality to Improve Availability

By performing simple clinical maneuvers to improve donor lung quality as part of the San Antonio Lung Transplant (SALT) protocol, researchers significantly increased the// number of available donor lungs and transplant procedures without compromising recipient pulmonary function, length of hospital stay or survival.

The study appears in the second issue for September 2006 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

Implemented in 2001, the SALT donor-management protocol applied to all potential organ donors evaluated for candidacy by the Texas Organ Sharing Alliance in San Antonio during the study until 2005. Its purpose was to increase the lung procurement rate without adversely affecting the overall survival rate of lung transplant recipients.

Luis F. Angel, M.D., of the Division of Pulmonary and Critical Care Medicine at the University of Texas Health Science Center at San Antonio, and 12 associates reviewed data from 711 potential lung donors listed between September 1, 1997, and August 31, 2005.

During the four-year SALT donor management period studied, 121 lungs were transplanted, as contrasted to 53 during the prior four years before the management program started.

“Of the 98 actual lung donors during the protocol (SALT) period, 53 had initially been considered poor donors,” said Dr. Angel. “These donors ultimately provided 64, or 53 percent, of the 121 lung transplants. The type of donor was not associated with significant differences in recipients’ 30-day and 1-year survival rates or any clinical measures of adequate graft function.”

According to the study, the problem of donor lung availability is a very serious one. In 2005, nearly 3,000 patients were on a national waiting list for lung transplantation. However, only 35 percent of these patients received transplants, while 10 percent died awaiting an organ. Approximate
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