Early United States experience with lung donation after circulatory death using thoracoabdominal normothermic regional perfusion

Thoracoabdominal normothermic regional perfusion (TA-NRP) has recently begun being utilized in the United States for recovery of cardiothoracic allografts from some donors after circulatory death (DCD), but data on lungs recovered in this method is limited to case reports. We conducted a national retrospective review of lung transplants from DCD donors recovered using TA-NRP. Of the 434 total DCD lung transplants performed between January 2020 and March 2022, 17 were recovered using TA-NRP. Compared to direct recovery DCD transplants, recipients of TA-NRP DCD transplants had lower likelihood of ventilation >48 hours (23.5% vs 51.3%, p = 0.027) and similar likelihood of predischarge acute rejection, requirement for extracorporeal membrane oxygenation at 72 hours, hospital lengths of stay, and survival at 30, 60, and 90 days post-transplant. These early data suggest that DCD lung recov-ery using TA-NRP might be a safe way to further expand the donor pool and warrant further study. J Heart Lung Transplant 2023;42:693-696 (c) 2023 International Society for Heart and Lung Transplantation. All rights reserved.

Automated summary

Thoracoabdominal normothermic regional perfusion (TA-NRP) is a method used in the United States to recover cardiothoracic allografts from donors after circulatory death (DCD). Limited data on lung transplants using TA-NRP has prompted a national retrospective review. The study found that recipients of TA-NRP DCD transplants had a lower likelihood of prolonged ventilation and similar outcomes to direct recovery DCD transplants.