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Are too many lungs not being considered for transplantation? (p 621)

N.B. Please note that if you are outside North America the embargo date for all Lancet Press material is 0001 hours UK time Friday 23 August 2002

Lancet

Authors of a research letter in this week's issue of THE LANCET suggest that new scientific evidence is required to clarify the criteria for assessing potential lung donors.

More than 85% of lungs are considered unsuitable for transplantation. Lorraine Ware from Vanderbilt University School of Medicine, Nashville, USA, and Michael Matthay and colleagues from The University of California at San Francisco, USA, assessed whether potentially suitable lungs for transplantation are being rejected because the existing criteria for rejection are too rigid.

The investigators obtained 29 pairs of rejected lungs and assessed them by physiological, microbiological, and histological methods. When all factors were considered, including microbiological and non-lung donor factors, approximately 40% of pairs of rejected lungs might have been potentially suitable for transplantation--which could have potentially resulted in a marked increase in the number of lungs that could have been used for lung transplantation.

Lorraine Ware comments: "Our results, combined with reports of successful outcomes with lungs from marginal donors, highlight the urgent need for a prospective, scientific assessment of selection of donors for lung transplantation."

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Contact: Dr Lorraine B Ware, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, T1217 MCN Nashville, TN 37232-2650, USA; T) +1 615 322 7872; F) +1 615 343 7448; E) lorraine.ware@Vanderbilt.Edu or Dr Michael A Matthay, Pulmonary and Critical Care Division, University of California School of Medicine, T) +1 415 353 1206; F) +1 415 353 1990; E) mmatt@itsa.ucsf.edu

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