Lung transplant outcomes in organ donation care centers

PHILADELPHIA — A new study by researchers at the University of Pennsylvania found that The study, published today, is the first to reveal differences in lung transplant outcomes between organs retrieved from two types of deceased organ donation care facilities operating in the United States. JAMA Network Openprovides insights that can improve the organ donation and transplant process for patients across the country.

In the United States, deceased organ donors have traditionally been cared for in hospitals, where organs are rehabilitated, transplant recipients are identified, and intensive care and testing required for organ recovery surgery is performed. Over the past two decades, some donors have been transferred from hospitals to Donor Care Units (DCUs), which provide similar services but only for deceased donors. Currently, two types of DCUs operate in the United States: freestanding (located outside of an acute care hospital) and hospital-based DCUs.

The researchers analyzed lung donation rates and lung graft survival rates for nearly 11,000 deceased donors who underwent organ retrieval surgery between April 2017 and June 2022. The researchers hypothesized that there would be no significant difference in lung graft survival rates between organs retrieved from donors managed in these two types of units. However, the study showed that while independent donor centers generally have higher donation rates, recipients of lungs from hospital-based DCUs survive longer.

“These findings may spur improvements in how organ donors are managed nationwide, ultimately increasing the quality and availability of donated organs,” said study leader Emily Vail, MD, MSc, assistant professor of anesthesiology and critical care at the University of Pennsylvania Perelman School of Medicine and senior research fellow at the Leonard Davis Institute for Health Economics. This study highlights that our system of care for deceased organ donors is evolving and has the potential to significantly improve organ quality and increase the number of available organs per donor.

Vail's research is especially important given the fragile nature of lung tissue and the strict criteria for lung donation: only around 20% of deceased donors are eligible to donate lungs, making efficient and effective donor management practices essential.

When launched in late 2022, the Gift of Life Donor Care Center at the University of Pennsylvania School of Medicine will be one of at least 15 hospital-based DCUs currently operating in the U.S. Gift of Life transplant coordinators work with a multidisciplinary team of intensivists, nurses, respiratory therapists and pharmacists to provide specialized care and support to deceased organ donors who have been diagnosed as brain dead and cleared for organ donation. The Gift of Life Donor Care Center serves hospitals and donor families throughout eastern Pennsylvania, southern New Jersey and Delaware.

This research was funded by the U.S. Health and Medical Research Agency (5K12HS026372-05), the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK070869, K24AI146137), and the National Heart, Lung, and Blood Institute (K24HL115353).