Utilization of Marginal Lung Donors with Low PaO2/FiO2 ratio and High Body Mass Index

Abstract Background Lungs of donors with high body mass index (BMI) have more atelectasis and lower PaO2/FiO2 (P/F) ratio than those with normal BMI. This study prospectively evaluated outcomes of a new approach for these lungs in our lung transplant program. Methods From 2/2016—12/2018, 336 lung transplants were performed at Cleveland Clinic. Of these, 58 met criteria for our aggressive approach to donors with P/F ratio Results Of the 58 donors, 33 were converted to straight lung transplantation because they demonstrated significant improvement of P/F ratio after lung recruitment compared with P/F ratio at lung offer [median 278 vs. 420 mmHg, p Conclusions These data suggest that atelectasis in high BMI donors contributes to P/F ratios