Healthy lungs are scarce among available organ donors who are becoming progressively older and have increasing numbers of comorbidities. Selection criteria that include excellent oxygenation and complete inflation may lead to the exclusion of organs with potential for adequate post-transplant function.

Autopsy reports were reviewed as an element of performance improvement efforts at one Organ Procurement Organization (OPO) with an aggressive program of lung donation. Anatomic findings in the lungs were correlated with the UNOS codes that identified the reasons the organs were declined for recovery and transplantation.

During a two year period (2015-2016) 75 complete autopsy reports from patients from whom at least 1 organ was recovered for transplantation were reviewed.

Overall, 41 lungs had no pathologic findings, including 4 from patients without authorization for lung donation and 6 that were declined upon visualization. Additional analysis of these cases to understand missed opportunities for donor management that may have led to additional transplantable organs. These data are being shared with our stakeholders at lung transplant centers to help in their performance improvement efforts, particularly with respect to intraoperative organ evaluation and selection. We conclude that the potential for transplantation of anatomically suitable organs has not been optimized. Additional opportunities for lung transplantation are present within our current deceased donor pool.

CITATION INFORMATION: Friedman A, Lewis J, Irving H, Delli Carpini K. Truth in Pathology: Autopsy Findings in Lungs Declined for Transplantation. Am J Transplant. 2017;17 (suppl 3).

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