Lung Transplantation and Utilisation Following Donation after Circulatory Death (DCD) in the UK

Purpose The number of potential donors after circulatory death (DCD) in the UK is increasing. DCD lung transplantation commenced in the UK in 2002 and is performed in 5 UK lung transplant centres. The aim of this study is to review the UK experience in lung utilisation and transplantation in DCD lung transplant. Methods Data on all adult lung offers (where at least 1 solid organ was donated) and transplants performed in the UK, between December 2002 and December 2018 were obtained from the UK Donor and UK Transplant Registries. Data were grouped by donor type, DCD or DBD. Donor and recipient characteristics and outcomes were compared between groups using the Wilcoxon, Chi-squared or log-rank tests as appropriate. Results There were 10993 organ donors who had lungs offered during the analysis period, of which 2095 (19%) were DCD. A total of 2571 adult lung transplants were performed, 316 (12%) of which were DCD. Both the number of potential lung DCD donors and the number of DCD lung transplants have increased over time. The proportion of DCD lung transplants in the UK has increased from 9% in 2008 to 21% in 2018. Utilisation for DCD lung offers is 15%, ranging from 10-17% each year. Utilisation for DBD donors during the period of analysis was 25%. There was no significant difference in donor age. In univariate analysis, DCD had significantly longer ischaemic times (7.1 hours vs 5.6 hours p= Conclusion The number of potential DCD lung donors and the number of DCD lung transplants in the UK have increased exponentially since 2002. DCD lung transplants now account for 21% of UK lung transplant activity. Previous analysis of the UK DCD experience had shown comparable early and 1-year outcomes. Further analysis is required to understand significant differences in early survival for DCD lung recipients in the UK.