Background: Lung (LU) utilization from deceased donors (DD) is considerably lower than for kidney, liver and heart. A better understanding of placement efforts may provide insight into potential process improvements.

Data: All DD (excl. DCD) recovered in 2009-2013 were analyzed. OPTN data were used to determine if: a LU match was run; offers were made; or a LU was transplanted (TXed). Location was based on thoracic allocation zones: 500-mile circles centered at the donor hospital.

Results: The cohort had 35272 DD, with 8929 LU or heart-lung TXs; 2626 (7%) were <15 years old and 3124 (9%) were ≥65 years.

Figure 1. Placement efforts by donor age

Placement efforts differed by donor age (p < 0.0001). The % without a match run increased with age, from 20% of infants to 87% of the oldest donors. (DD were ≥65 years in 1% of LU TXs.) Overall, there was 1 donor TXed per 2 offered. For infants and donors ≥70 years old, the ratio was 1 to 7; the ratio was 2 to 3 in 15-24 year olds.

The furthest location per donor was tabulated for donors with at least one LU TXed (LTD) and with LU offered but not TXed (OD).

Figure 2. Location of transplant and furthest offer

Only 7% of LTD were TXed in zone B (>500-1000 miles) or beyond, while almost 40% of OD had an offer in zone B or beyond. There were 33 (0.4%) LTD in zone D (>1500-2500 miles), and 0 in zone E (>2500 miles). Almost 14% of the OD were offered in zone D or E.

The distribution of location differed by age group for LTD and for OD (both with p < 0.0001). LTD at either age extreme were more likely to be TXed at a further location, with a similar result for OD being offered.

Conclusions: LU offers were made for almost half of DD, though a LU was TXed from only 23% of donors. TXs were rare beyond zone B. In the extreme ages, >30% of OD had offers to zone C or beyond.

« Back to 2015 American Transplant Congress