Does Hanging Donors Be Really Marginal for Lung Transplantation

Success of lung transplantation (LTx) depends on several factors, including the selection of the donor. Hanging donors are mostly excluded, based on pulmonary edema, barotrauma and hypoxia. However there is no evidence of higher LTx morbidity-mortality with lungs providing by suicidal hanging. All lung transplantation performed at Foch hospital between January 2010 and July 2015 were analyzed outcomes of LTx to compare hanging donors (Hanging group) with donors having other cause of death (Control group). During this period 299 LT were performed and divided in 2 groups: Hanging group (N=20) and Control group (N=279). Donor characteristics did not differ in age, sex, time on mechanical ventilation before retrieval, PO2/FIO2 ratio, smoking history, chest Xray or bronchial secretion. Recipient diagnoses did not differ significantly between the both groups. Primary graft dysfunction (PGD) at 72 hours was no statistically significant between Hanging group (PGD 0-1 70%, PGD 2 20% and PGD 3 10%) and Control group (PGD 0-1 61%, PGD 2 23% and PGD 3 16%) Median of post-operative mechanical ventilation duration (1 [range, 0-84] vs 1 [range, 0-435] days), intensive care unit stays (7 [range, 2-66] vs 7 [range, 2-91] days), and total hospital lengths of stay (31 [range, 20-84] vs 32 [range, 12-410] days) did not differ significantly between the two groups. The percentage predicted forced expiratory volume in 1 second at 6 months and 12 months were comparable in both groups (6 months, p=0,94; 12 months, p=0,05). No statistically significant differences were found on the survival between Hanging group and the Control group with respectively at 1 year (83% and 85%) and 2 years (75% and 80%) (p=0,76). The LT outcomes are not different between hanging donors and the others cause of death. Hanging donors should be considered as conventional donors.