Lung transplantation from nonheparinized category III non-heart-beating donors. A single-centre report.

Background: Despite the increasing use of extended lung donors, the shortage of lung donors remains. Usage of non-heart-beating (NHB) lung donors contributes to fight this shortage. We describe our experience in 21 consecutive adult lung transplantations using nonheparinized category III NHB donors and standard flush preservation.

Methods: From January 2005 to December 2008, we collected donor and recipient data of all NHB category III lung transplantations performed in our center. For comparison, we also collected the data of all heart-beating (HB) lung transplantations in the same period. We focused on data describing the donor, the donor procedure, the recipient's primary graft dysfunction, survival, rejection episodes, and the lung graft function.

Results: Twenty-one NHB and 77 HB lung transplantations were performed. Circulation arrest occurred after 14 (4-62) min and warm ischemia time was 30 (19-44) min. Occurrence of primary graft dysfunction, acute rejection episodes, development of bronchiolitis obliterans syndrome was equal to the HB cohort as was the 2 years survival of 95% in the NHB group compared with 86% in the HB group. Lung graft function during the first 2 years tended to be better preserved in the NHB group.

Conclusion: Category III NHB lung donation is a good alternative in addition to HB lung donation. Using nonheparinized category III NHB donors and standard ante- and retrograde, flush perfusion resulted in good lung graft function and survival. NHB donation offers a great opportunity to reduce the burden of donor lung shortage.