Impacts of Donor Smoking History and Age on Lung Transplant Survival

s S271 Purpose: Extended criteria donor lungs are increasingly used for transplantation. The arterial partial pressure of oxygen of donors at organ offer is widely regarded as an important marker for the quality and transplantability of the lung. More precise, a PaO2/FiO2 300 mmHg. Methods: 464 consecutive lung transplantations performed at our centre between April 2010 and October 2013 were analyzed. Outcome parameters included overall survival, hospital mortality and correlation of duration of postoperative ventilation. Results: 70 patients received grafts of donors with PaO2/FiO2 300. There were no significant recipient differences in age (45.6±0.8 vs. 48.3±1.5 yrs, p= 0.12) or sex (51% vs. 53% male). Postoperative parameters of the recipients including duration of mechanical ventilation time (14 [2-1619] hours vs. 27 [2-4077] hours; p= 0.14), intensive care stay (2 [1-49] days vs. 3 [3-203] days; p= 0.12) or total hospital stay (23 [11-199] days vs. 26 [11-224] days; p= 0.54) showed no significant differences between both groups. Also, hospital mortality (4.2% vs. 5.1%; p= 0.78) did not differ. Overall survival of the recipients showed no significant difference (p= 0.56). Further differentiation into subgroups according to donor oxygenation (PaO2/FiO2 300) showed no significant difference in survival (p= 0.52). Donor characteristics showed longer duration of mechanical ventilation in the group with a PaO2/FiO2< 300 (6.9±0.6 days vs. 5.3±0.2 days; p= 0.01). Correlation analysis showed no significant correlation between donor PaO2/FiO2 and recipient postoperative ventilation time (p= 0.49) or total hospital stay (p= 0.12). Conclusion: Donor lungs showing low arterial PaO2 values at offer can safely be used for transplantation, if a structural damage to the organ is excluded during retrieval. We conclude that a further increase of usage of donor organs that might have a compromised oxygenation capacity before retrieval should be attempted.