Purpose

Suicidal hanging causes compression of the neck blood vessels and the airway leading to hypoxic brain damage due to cerebral ischemia and respiratory distress. Hanging, in addition to global tissue hypoxia, affects particularly the lungs due to pulmonary oedema and barotrauma. There is little evidence in literature about transplantation of lungs from hanging donors. This study evaluates the outcome of lung transplantation utilizing organs from this group.

Methods

Retrospective analysis of lung offers between 01.2007 and 10.2012 with hanging as cause of death was performed. The outcomes of lung transplantation in cases with lungs from hanging donors were compared with donors of the other causes of death.

Results

2662 offers were received in this period in which 99 (3.7%) had hanging as a cause of death. Of those, 67 (68%) organs were declined at initial offer due to poor function and lack of suitable recipient as a commonest cause. Hanging was a primary cause for organ declining in 2 and secondary in 8 donors. 32 (32%) organs were assessed by retrieval team and only 6 (6%) of them were retrieved and transplanted.

Outcomes of lung transplantations utilizing organs from donors with hanging as a cause of death (n=6) were compared with the ones with other causes of death (n=231) during that period. Baseline recipient cahracteristics: age (p=0.348), gender (p=0.683), diagnosis and baseline donor characteristics: age (p=0.255), gender (p=0.680), PaO2/FiO2 ratio (p=0.233), mechanical ventilation duration (p=0.181), percentage of DCD (p=1.000) and donors from extended donor criteria, and total ischemic time (p=0.258) were comparable in both the groups (hanging vs. other causes of donor death). Post-transplantation characteristics: PaO2/FiO2 ratio at arrival (p=0.743), 24 (p=0.703), 48 (p=0.499) and 72 (p=0.615) hours, duration of mechanical ventilation (p=0.315), ITU (p=0.309) and hospital stay (p=0.314) were comparable. 1 year survival estimate was not different as well: hanging vs. other donor lungs 83 vs. 85%, log rank=0.99.

Conclusion

Suicidal hanging is relatively rare cause of death for potential organ donors. It should not be considered as a contraindication for lung donation by itself, because in selected cases, this type of organ might be transplanted with very good results.

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