Second Chance Lungs: Can Ventilated Donors Expand Lung Transplant Options?

Q: What is the main challenge addressed in this research?

The primary issue addressed is the shortage of donor lungs for transplantation. The demand for lung transplants surpasses the available supply, leading to extended waiting times and, regrettably, fatalities. This scarcity motivates exploration into expanding the donor pool, particularly by considering lungs from donors who have undergone prolonged mechanical ventilation, a category often excluded due to concerns about lung viability.

Q: Why is prolonged mechanical ventilation a concern in lung transplantation?

Prolonged mechanical ventilation, defined as ventilation for more than 5 days, raises concerns about lung damage and function. Historically, lungs from donors with this characteristic have been classified as 'marginal' and frequently rejected. However, the research suggests that with careful assessment and management, these lungs can still offer viable transplant options, broadening the scope of available donor organs and potentially reducing the number of patients awaiting transplantation.

Q: How did the research compare outcomes between different ventilation durations?

The research compared outcomes in lung transplants using lungs from donors with short-term ventilation (less than 5 days) and long-term ventilation (5 days or more). The study included 81 patients, retrospectively analyzed. Key outcomes such as the incidence of primary graft dysfunction, acute rejection, pneumonia, and bronchial complications were compared between the groups. Also, chronic lung allograft dysfunction-free survival and overall survival rates were evaluated to determine if the duration of mechanical ventilation impacted the long-term success of the transplants.

Q: What were the key findings of the research regarding prolonged ventilation?

The research revealed that, despite the longer ventilation period, the outcomes were comparable between the two groups. There was no significant difference in the incidence of complications like primary graft dysfunction, acute rejection, pneumonia, or bronchial complications. Furthermore, chronic lung allograft dysfunction-free survival and overall survival rates were similar. This suggests that lungs from donors ventilated for longer than 5 days can be successfully transplanted, offering similar results to those from donors with shorter ventilation periods.

Q: What are the implications of these findings for lung transplantation?

The implications are significant. The findings support the potential to increase the number of available donor organs, possibly alleviating the shortage of donor lungs and potentially reducing waiting times and improving outcomes for lung transplant candidates. It opens up possibilities for utilizing lungs that were previously considered unsuitable, thereby broadening the pool of donors and offering hope to more patients in need of a life-saving transplant. This research underscores the importance of expanding and refining the criteria for donor lung selection to maximize the number of transplants possible.

Mira Elwood in Health & Wellness June 2025 • 4 min read.

"Research explores the viability of using lungs from donors mechanically ventilated for extended periods, potentially increasing the donor pool."

The demand for lung transplants far exceeds the supply of available organs, leading to prolonged waiting times and, unfortunately, many deaths. This scarcity has prompted researchers to explore unconventional avenues for expanding the donor pool, including the use of lungs from donors who might have previously been deemed unsuitable.

One such area of investigation focuses on lungs from donors who required mechanical ventilation for an extended period. Typically, lungs from donors ventilated for more than 5 days are considered marginal and often declined due to concerns about potential damage and reduced function. However, with careful evaluation and management, these lungs might still offer a viable option for patients in desperate need.

This article examines recent research into the feasibility of using lungs from donors mechanically ventilated for prolonged periods, assessing the outcomes of lung transplants performed with these organs and exploring the potential benefits and risks involved. By understanding the findings, we can gain insights into whether this approach could help alleviate the organ shortage and improve outcomes for lung transplant candidates.

Prolonged Ventilation: Does It Compromise Lung Transplant Success?

Lungs emerging from a field of wind turbines, symbolizing breath and energy transition.

A study published in The Journal of Heart and Lung Transplantation investigated the outcomes of lung transplants using lungs from donors ventilated for both short (<5 days) and long (≥5 days) durations. The researchers retrospectively analyzed data from 81 patients who underwent lung transplantation at their institution between January 2001 and May 2017.

The study compared the outcomes of 31 patients who received lungs from donors ventilated for a short term (ST group) with 50 patients who received lungs from donors ventilated for a long term (LT group). The median duration of mechanical ventilation was significantly longer in the LT group (8.5 days) compared to the ST group (3 days).

Despite the longer ventilation period, the study found that the lung donor score and other donor characteristics were similar between the two groups.
There was no significant difference in the incidence of primary graft dysfunction, acute rejection, pneumonia, or bronchial complications between the groups.
Chronic lung allograft dysfunction-free survival was similar in both groups, and the overall survival rate after lung transplantation was comparable between the LT and ST groups (5-year survival rate: 66.6% vs. 75.2%).

These findings suggest that lungs from donors ventilated for greater than 5 days can provide favorable results in both the acute and chronic phases after transplantation. This approach could be a feasible strategy to alleviate the donor organ shortage, expanding the pool of available lungs for transplantation.

Expanding the Horizon of Lung Transplantation

The research highlights the potential for safely utilizing lungs from donors who required prolonged mechanical ventilation, a practice that could significantly increase the number of available organs for transplantation. This is particularly crucial given the persistent shortage of donor lungs and the growing number of patients awaiting transplantation.

While the study provides encouraging results, it's important to acknowledge that careful donor selection and meticulous evaluation of lung function are essential to ensure successful transplant outcomes. Further research is needed to identify specific criteria for identifying suitable candidates among donors ventilated for extended periods.

By refining donor selection strategies and optimizing post-transplant management, the use of lungs from donors mechanically ventilated for prolonged periods could become a valuable tool in addressing the organ shortage and improving the lives of patients with end-stage lung disease.

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This article is based on research published under:

DOI-LINK: 10.1016/j.healun.2018.01.616, Alternate LINK

Title: The Feasibility Of Lung Transplantation From Donors Mechanically Ventilated For Prolonged Periods

Subject: Transplantation

Journal: The Journal of Heart and Lung Transplantation

Publisher: Elsevier BV

Authors: S. Sugimoto, M. Yamane, T. Kurosaki, S. Otani, S. Toyooka, T. Oto

Published: 2018-04-01

Everything You Need To Know

What is the main challenge addressed in this research?

The primary issue addressed is the shortage of donor lungs for transplantation. The demand for lung transplants surpasses the available supply, leading to extended waiting times and, regrettably, fatalities. This scarcity motivates exploration into expanding the donor pool, particularly by considering lungs from donors who have undergone prolonged mechanical ventilation, a category often excluded due to concerns about lung viability.

Why is prolonged mechanical ventilation a concern in lung transplantation?

Prolonged mechanical ventilation, defined as ventilation for more than 5 days, raises concerns about lung damage and function. Historically, lungs from donors with this characteristic have been classified as 'marginal' and frequently rejected. However, the research suggests that with careful assessment and management, these lungs can still offer viable transplant options, broadening the scope of available donor organs and potentially reducing the number of patients awaiting transplantation.

How did the research compare outcomes between different ventilation durations?

The research compared outcomes in lung transplants using lungs from donors with short-term ventilation (less than 5 days) and long-term ventilation (5 days or more). The study included 81 patients, retrospectively analyzed. Key outcomes such as the incidence of primary graft dysfunction, acute rejection, pneumonia, and bronchial complications were compared between the groups. Also, chronic lung allograft dysfunction-free survival and overall survival rates were evaluated to determine if the duration of mechanical ventilation impacted the long-term success of the transplants.

What were the key findings of the research regarding prolonged ventilation?

The research revealed that, despite the longer ventilation period, the outcomes were comparable between the two groups. There was no significant difference in the incidence of complications like primary graft dysfunction, acute rejection, pneumonia, or bronchial complications. Furthermore, chronic lung allograft dysfunction-free survival and overall survival rates were similar. This suggests that lungs from donors ventilated for longer than 5 days can be successfully transplanted, offering similar results to those from donors with shorter ventilation periods.

What are the implications of these findings for lung transplantation?

The implications are significant. The findings support the potential to increase the number of available donor organs, possibly alleviating the shortage of donor lungs and potentially reducing waiting times and improving outcomes for lung transplant candidates. It opens up possibilities for utilizing lungs that were previously considered unsuitable, thereby broadening the pool of donors and offering hope to more patients in need of a life-saving transplant. This research underscores the importance of expanding and refining the criteria for donor lung selection to maximize the number of transplants possible.