Japanese strategies to maximize heart and lung availabilities: Experience from 100 consecutive brain-dead donors

N. Fukushima, M. Ono, S. Saito, Y. Saiki, S. Kubota, Y. Tanoue, M. Minami, S. Konaka, J. Ashikari

研究成果: ジャーナルへの寄稿記事

10 引用 (Scopus)

抄録

Objective Because the donor shortage is extremely severe in Japan because of a strict organ transplantation law, special strategies have been established to maximize heart and lung transplantations (HTs and LTs, respectively). We reviewed 100 consecutive brain-dead donors to evaluate our strategies to identify and manage heart and lung donors. Methods We retrospectively reviewed all 100 consecutive brain-dead donors procured since the law was issued in 1997. There were 56 mens and the overall mean donor age was 43.5 years. The causes of death were cerebrovascular disease (n = 62), head trauma (n = 20), and asphyxia (n = 16): Since November 2002, special transplant management doctors were sent to donor hospitals to assess cardiac and lung functions, seeking to identify transplant opportunities. They stabilized donor hemodynamics and lung function by administering antidiuretic hormone intravenously and performing bronchofibroscopy for pulmonary toilet. Results Seventy-nine HTs, 1 heart-lung transplantations, and 78 LTs (46 single and 32 bilateral) were performed. By applying these strategies organs per donor were increased from 4.5 to 6.8. Among heart donors, 61/80 were marginal: high inotrope requirement (n = 29), cardiopulmonary resuscitation (n = 28), and/or >55 years old (n = 20). None of the 80 HT recipients died of primary graft failure (PGF). Patient survival rate at 10 years after HT was 95.4%. Among lung donors, 48/65 were marginal: pneumonia (n = 41), chest trauma (n = 4), and >55 years old (n = 9). Only 2/78 LT recipients died of PGF. Patient survival rate at 3 years after LT was 72.2%. After inducing frequent pulmonary toilet, lung procurement and patient survival rates increased significantly after LT. Conclusions Although the number of cases was still small, the availability of organs has been greater and the outcomes of HT/LT acceptable.

元の言語英語
ページ(範囲)2871-2874
ページ数4
ジャーナルTransplantation Proceedings
45
発行部数8
DOI
出版物ステータス出版済み - 10 1 2013

Fingerprint

Brain Death
Tissue Donors
Lung
Heart-Lung Transplantation
Transplants
Survival Rate
Cerebrovascular Disorders
Asphyxia
Cardiopulmonary Resuscitation
Organ Transplantation
Vasopressins
Craniocerebral Trauma
Cause of Death
Pneumonia
Japan
Thorax
Hemodynamics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

これを引用

Japanese strategies to maximize heart and lung availabilities : Experience from 100 consecutive brain-dead donors. / Fukushima, N.; Ono, M.; Saito, S.; Saiki, Y.; Kubota, S.; Tanoue, Y.; Minami, M.; Konaka, S.; Ashikari, J.

:: Transplantation Proceedings, 巻 45, 番号 8, 01.10.2013, p. 2871-2874.

研究成果: ジャーナルへの寄稿記事

Fukushima, N, Ono, M, Saito, S, Saiki, Y, Kubota, S, Tanoue, Y, Minami, M, Konaka, S & Ashikari, J 2013, 'Japanese strategies to maximize heart and lung availabilities: Experience from 100 consecutive brain-dead donors', Transplantation Proceedings, 巻. 45, 番号 8, pp. 2871-2874. https://doi.org/10.1016/j.transproceed.2013.08.037
Fukushima, N. ; Ono, M. ; Saito, S. ; Saiki, Y. ; Kubota, S. ; Tanoue, Y. ; Minami, M. ; Konaka, S. ; Ashikari, J. / Japanese strategies to maximize heart and lung availabilities : Experience from 100 consecutive brain-dead donors. :: Transplantation Proceedings. 2013 ; 巻 45, 番号 8. pp. 2871-2874.
@article{8414328114cd4aa999ab90329f9f69b8,
title = "Japanese strategies to maximize heart and lung availabilities: Experience from 100 consecutive brain-dead donors",
abstract = "Objective Because the donor shortage is extremely severe in Japan because of a strict organ transplantation law, special strategies have been established to maximize heart and lung transplantations (HTs and LTs, respectively). We reviewed 100 consecutive brain-dead donors to evaluate our strategies to identify and manage heart and lung donors. Methods We retrospectively reviewed all 100 consecutive brain-dead donors procured since the law was issued in 1997. There were 56 mens and the overall mean donor age was 43.5 years. The causes of death were cerebrovascular disease (n = 62), head trauma (n = 20), and asphyxia (n = 16): Since November 2002, special transplant management doctors were sent to donor hospitals to assess cardiac and lung functions, seeking to identify transplant opportunities. They stabilized donor hemodynamics and lung function by administering antidiuretic hormone intravenously and performing bronchofibroscopy for pulmonary toilet. Results Seventy-nine HTs, 1 heart-lung transplantations, and 78 LTs (46 single and 32 bilateral) were performed. By applying these strategies organs per donor were increased from 4.5 to 6.8. Among heart donors, 61/80 were marginal: high inotrope requirement (n = 29), cardiopulmonary resuscitation (n = 28), and/or >55 years old (n = 20). None of the 80 HT recipients died of primary graft failure (PGF). Patient survival rate at 10 years after HT was 95.4{\%}. Among lung donors, 48/65 were marginal: pneumonia (n = 41), chest trauma (n = 4), and >55 years old (n = 9). Only 2/78 LT recipients died of PGF. Patient survival rate at 3 years after LT was 72.2{\%}. After inducing frequent pulmonary toilet, lung procurement and patient survival rates increased significantly after LT. Conclusions Although the number of cases was still small, the availability of organs has been greater and the outcomes of HT/LT acceptable.",
author = "N. Fukushima and M. Ono and S. Saito and Y. Saiki and S. Kubota and Y. Tanoue and M. Minami and S. Konaka and J. Ashikari",
year = "2013",
month = "10",
day = "1",
doi = "10.1016/j.transproceed.2013.08.037",
language = "English",
volume = "45",
pages = "2871--2874",
journal = "Transplantation Proceedings",
issn = "0041-1345",
publisher = "Elsevier USA",
number = "8",

}

TY - JOUR

T1 - Japanese strategies to maximize heart and lung availabilities

T2 - Experience from 100 consecutive brain-dead donors

AU - Fukushima, N.

AU - Ono, M.

AU - Saito, S.

AU - Saiki, Y.

AU - Kubota, S.

AU - Tanoue, Y.

AU - Minami, M.

AU - Konaka, S.

AU - Ashikari, J.

PY - 2013/10/1

Y1 - 2013/10/1

N2 - Objective Because the donor shortage is extremely severe in Japan because of a strict organ transplantation law, special strategies have been established to maximize heart and lung transplantations (HTs and LTs, respectively). We reviewed 100 consecutive brain-dead donors to evaluate our strategies to identify and manage heart and lung donors. Methods We retrospectively reviewed all 100 consecutive brain-dead donors procured since the law was issued in 1997. There were 56 mens and the overall mean donor age was 43.5 years. The causes of death were cerebrovascular disease (n = 62), head trauma (n = 20), and asphyxia (n = 16): Since November 2002, special transplant management doctors were sent to donor hospitals to assess cardiac and lung functions, seeking to identify transplant opportunities. They stabilized donor hemodynamics and lung function by administering antidiuretic hormone intravenously and performing bronchofibroscopy for pulmonary toilet. Results Seventy-nine HTs, 1 heart-lung transplantations, and 78 LTs (46 single and 32 bilateral) were performed. By applying these strategies organs per donor were increased from 4.5 to 6.8. Among heart donors, 61/80 were marginal: high inotrope requirement (n = 29), cardiopulmonary resuscitation (n = 28), and/or >55 years old (n = 20). None of the 80 HT recipients died of primary graft failure (PGF). Patient survival rate at 10 years after HT was 95.4%. Among lung donors, 48/65 were marginal: pneumonia (n = 41), chest trauma (n = 4), and >55 years old (n = 9). Only 2/78 LT recipients died of PGF. Patient survival rate at 3 years after LT was 72.2%. After inducing frequent pulmonary toilet, lung procurement and patient survival rates increased significantly after LT. Conclusions Although the number of cases was still small, the availability of organs has been greater and the outcomes of HT/LT acceptable.

AB - Objective Because the donor shortage is extremely severe in Japan because of a strict organ transplantation law, special strategies have been established to maximize heart and lung transplantations (HTs and LTs, respectively). We reviewed 100 consecutive brain-dead donors to evaluate our strategies to identify and manage heart and lung donors. Methods We retrospectively reviewed all 100 consecutive brain-dead donors procured since the law was issued in 1997. There were 56 mens and the overall mean donor age was 43.5 years. The causes of death were cerebrovascular disease (n = 62), head trauma (n = 20), and asphyxia (n = 16): Since November 2002, special transplant management doctors were sent to donor hospitals to assess cardiac and lung functions, seeking to identify transplant opportunities. They stabilized donor hemodynamics and lung function by administering antidiuretic hormone intravenously and performing bronchofibroscopy for pulmonary toilet. Results Seventy-nine HTs, 1 heart-lung transplantations, and 78 LTs (46 single and 32 bilateral) were performed. By applying these strategies organs per donor were increased from 4.5 to 6.8. Among heart donors, 61/80 were marginal: high inotrope requirement (n = 29), cardiopulmonary resuscitation (n = 28), and/or >55 years old (n = 20). None of the 80 HT recipients died of primary graft failure (PGF). Patient survival rate at 10 years after HT was 95.4%. Among lung donors, 48/65 were marginal: pneumonia (n = 41), chest trauma (n = 4), and >55 years old (n = 9). Only 2/78 LT recipients died of PGF. Patient survival rate at 3 years after LT was 72.2%. After inducing frequent pulmonary toilet, lung procurement and patient survival rates increased significantly after LT. Conclusions Although the number of cases was still small, the availability of organs has been greater and the outcomes of HT/LT acceptable.

UR - http://www.scopus.com/inward/record.url?scp=84886269343&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84886269343&partnerID=8YFLogxK

U2 - 10.1016/j.transproceed.2013.08.037

DO - 10.1016/j.transproceed.2013.08.037

M3 - Article

C2 - 24156994

AN - SCOPUS:84886269343

VL - 45

SP - 2871

EP - 2874

JO - Transplantation Proceedings

JF - Transplantation Proceedings

SN - 0041-1345

IS - 8

ER -