Australia has made significant strides in improving organ donation rates, which has, in turn, increased the number of donor lung referrals for lung transplantation (LTx). The Alfred Hospital in Melbourne has provided a ‘behind the scenes’ view into the efficiency of these referrals and the use of donor lungs, which could prove invaluable for the future advancement of organ transplantation.
According to a study published in Heart, Lung & Circulation, the Alfred Hospital analysed all Donatelife Australia donor lung referrals for the year 2017. A total of 440 lung referrals were processed, with an equal split between local referrals from the state of Victoria, with a population of 6.4 million, and those from the Rest-of-Australia (ROA). Among these, 68% of Victorian and 48% of ROA referrals came via the donation after circulatory death (DCD) pathway.
The study, authored by prominent figures in the LTx field such as Gregory I. Snell, Bronwyn J. Levvey, and others from the Alfred Hospital and Monash University, revealed that from the 102 lung transplants performed, 32 represented 21% of 149 Victorian and 8% of 106 ROA DCD donors. In comparison, 70 represented 54% of Victorian and 24% of ROA donation after brain death (DBD) donors. The data illustrated a significantly higher utility of DBD donors compared to DCD donors.
One of the key findings was the age factor in donor utility: 80% of all donors under the age of 35 were used or had the potential to be used. This percentage dramatically dropped to 30% for donors older than 35 years. Moreover, a mere 13% of DCD and 44% of DBD donors over 65 years of age were utilised. These numbers indicate the possible reservations and complications associated with retrieving organs from older donors.
Furthermore, the challenges around the retrieval of older DCD lungs were significant due to logistics and resource considerations, suggesting that there’s a need for enhanced protocols and support to improve the recovery rates of DCD organs successfully. The Alfred Hospital boasts one of the highest donor conversion and LTx activity rates globally, with 11.1 LTx per-million-population. This achievement underscores the hospital’s commitment to optimising donor organ use. However, the study concludes that efforts to extend the Australian donor lung pool could focus on optimising DBD referrals further.
To accomplish this, the study recommends additional resources, including more staff and improved transport facilities. It also suggests tightening referral criteria and considering employing extended warm ischaemic time donors which could potentially increase recovery rates, particularly for DCD lung donors.
The findings of this retrospective study are a testament to Australia’s success in organ donation but also highlight critical areas for improvement in transplantation logistics and practice. By concentrating on these areas, it could lead to more lives being saved and an increase in the efficiency of organ donation and transplantation processes.
This article has a DOI of 10.1016/j.hlc.2019.04.007, indicating it has undergone peer review and can be reliably referenced in the academic community.
For those interested in more details about the intricacies of lung transplantation and donor organ utility, the following references can provide further insights:
1. Snell, G.I., et al. (2019). Donor Lung Referrals for Lung Transplantation: A ‘Behind The Scenes’ View. Heart, Lung & Circulation, 29(5), 793–799. https://doi.org/10.1016/j.hlc.2019.04.007
2. Levvey, B.J., et al. (2019). Positive Outcomes of Using Donor Organs From Donation After Circulatory Death: A Perspective From the Alfred Hospital Lung Transplant Service. Heart, Lung & Circulation, 28(11), 1652-1660. https://doi.org/10.1016/j.hlc.2018.09.015
3. Whitford, H., et al. (2018). The Expansion of the Lung Transplant Donor Pool with Anti-HLA Antibody Positive Donors. Transplantation, 102(9), 1509-1515. https://doi.org/10.1097/TP.0000000000002277
4. Westall, G.P., et al. (2018). The Potential of Donation After Circulatory Death Lung Donors to Expand the Donor Pool: An International Perspective. Clinical Transplantation, 32(5), e13226. https://doi.org/10.1111/ctr.13226
5. McGiffin, D., et al. (2017). An Overview of Heart Transplantation in Australia. Journal of Thoracic Disease, 9(8), 2435-2443. https://doi.org/10.21037/jtd.2017.07.67
Keywords
1. Lung Transplantation Referrals
2. Organ Donation Australia
3. Lung Donor Utilization
4. Donation After Circulatory Death
5. Donation After Brain Death
Using these keywords can help the article rank well on search engines for users looking for information about lung transplantation, organ donation challenges and outcomes, and specific data concerning Australian organ donor statistics and practices.