Nearly half of the donated lungs currently rejected for transplantation may actually be suitable, according to a preliminary study by scientists at Vanderbilt University and the University of California, San Francisco.
The study, published in the August 24 issue of the journal Lancet, concluded that existing criteria for rejection may be too rigid. Researchers used physiological, microbiological and other methods to assess 29 pairs of rejected lungs and found that 40 percent of the rejected lungs might have been candidates for transplantation -- more than doubling the number of potentially suitable donor lungs. Currently more than 85 percent of lungs are considered unusable for transplantation.
"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," said Lorraine B. Ware, MD, assistant professor in the Division of Allergy, Pulmonary and Critical Care Medicine at Vanderbilt University School of Medicine. Ware is lead author of the paper.
"If twice as many donor lungs are truly suitable for transplants, we could save an additional thousand lives a year in the U.S. alone," said Michael A. Matthay, MD, senior author on the paper and professor of medicine at UCSF. Matthay is associate director of the intensive care unit at the UCSF Medical Center.
Collaborators in the research and coauthors on the study are Y. Wang, MD, former postdoctoral research fellow, and X. Fang, MD, postdoctoral research fellow, both at the UCSF Cardiovascular Research Institute; M. Warnock, MD, UCSF professor emeritus in pathology; T.S. Hall, MD, UCSF assistant professor of cardiothoracic surgery; and T. Sakuma, MD, professor of thoracic surgery, Kanazawa Medical University, Kanazawa, Japan.
The research was supported by the National Institutes of Health.