Bronchial Stenosis After Lung Transplantation From cDCD Donors Using Simultaneous Abdominal Normothermic Regional Perfusion: A Single-center Experience

Fecha de publicación: 01/11/2023 Fecha Ahead of Print: 30/06/2023

Autores de IDIVAL

Víctor Manuel Mora Cuesta

Autor

victormanuel.mora@scsalud.es
David Iturbe Fernández

Autor

david.iturbe@scsalud.es
Laura Sánchez Moreno

Autor

laura.sanchezm@scsalud.es
María De Los Ángeles Ballesteros Sanz

Autor

mdelosangeles.ballesteros@scsalud.es
Pilar Alonso Lecue

Autor

palonso@idival.org
Eduardo Miñambres García

Autor

eduardo.minambres@scsalud.es
José Manuel Cifrián Martínez

Autor

josemanuel.cifrian@scsalud.es
Sara Naranjo Gozalo

Autor

sara.naranjo@scsalud.es

Autores ajenos al IDIVAL

Tello-Mena S
Izquierdo-Cuervo S
Ortíz-Portal F
Ferrer-Pargada D

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 3wk 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.

Datos de la publicación

ISSN/ISSNe:: 0041-1337, 1534-6080
Tipo:: Article
Páginas:: 2415-2423
DOI:: 10.1097/TP.0000000000004698

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Filiaciones

Mora-Cuesta VM:: Lung Transplant Unit, Respiratory Department Marqués de Valdecilla University Hospital, ERN-LUNG (European Reference Network on Rare Respiratory Diseases), Santander, Cantabria, Spain
Tello-Mena S:: Lung Transplant Unit, Respiratory Department Marqués de Valdecilla University Hospital, ERN-LUNG (European Reference Network on Rare Respiratory Diseases), Santander, Cantabria, Spain
Izquierdo-Cuervo S:: Lung Transplant Unit, Respiratory Department Marqués de Valdecilla University Hospital, ERN-LUNG (European Reference Network on Rare Respiratory Diseases), Santander, Cantabria, Spain
Iturbe-Fernández D:: Lung Transplant Unit, Respiratory Department Marqués de Valdecilla University Hospital, ERN-LUNG (European Reference Network on Rare Respiratory Diseases), Santander, Cantabria, Spain
Sánchez-Moreno L:: Thoracic Surgery, Lung Transplant Unit, Marqués de Valdecilla University Hospital, ERN-LUNG (European Reference Network on Rare Respiratory Diseases), Santander, Cantabria, Spain
Ballesteros MA:: Instituto de Investigación. Transplant Coordination Unit and Service of Intensive Care, University Hospital Marqués de Valdecilla-IDIVAL, School of Medicine, Universidad de Cantabria, Santander, Cantabria, Spain
Ortíz-Portal F:: Respiratory Department, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain
Ferrer-Pargada D:: Respiratory Department, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain
Miñambres-García E:: Instituto de Investigación. Transplant Coordination Unit and Service of Intensive Care, University Hospital Marqués de Valdecilla-IDIVAL, School of Medicine, Universidad de Cantabria, Santander, Cantabria, Spain
Cifrián-Martínez JM:: Lung Transplant Unit, Respiratory Department Marqués de Valdecilla University Hospital, ERN-LUNG (European Reference Network on Rare Respiratory Diseases), Santander, Cantabria, Spain
Naranjo-Gozalo S:: Thoracic Surgery, Lung Transplant Unit, Marqués de Valdecilla University Hospital, ERN-LUNG (European Reference Network on Rare Respiratory Diseases), Santander, Cantabria, Spain