Lung Transplant Service, Alfred Hospital and Monash University, Melbourne, Victoria, Australia.
Curr Opin Organ Transplant. 2009 Oct;14(5):471-6. doi: 10.1097/MOT.0b013e32832fb9e1.
The scarcity of suitable donor organs continues to limit lung transplantation, resulting in long waiting times and significant mortality for those patients listed for transplant. Strategies to expand the donor pool can substantially lift donor lung utilization rates from historically low levels of less than 20% to rates greater than 50%. This article reviews recent developments in the selection, assessment and management of the potential lung donor that aim to increase donor organ use.
Close adherence to the originally published lung transplant donor acceptability criteria has historically restricted the number of donor lungs available for transplant. Important advances that aim to increase donor lung utilization include the use of donation after cardiac death lungs, cut-down lungs and expanded criteria lungs. Emerging diagnostic tools that predict how donor lungs will function after transplant are likely to facilitate selection of appropriate donor lungs significantly in the future.
Optimal donor management should aim to maximize lung donation through aggressive donor management and consideration of the complete and expanded donor pool. However, long-term studies are required to validate such an approach and to confirm that long-term outcomes are not being compromised by the use of both traditional and nontraditional organ donors.
合适供体器官的稀缺性继续限制肺移植的开展，导致等待移植的患者等待时间延长，死亡率显著增加。扩大供体库的策略可以将供体肺的利用率从历史上的不足 20%大幅提高到 50%以上。本文综述了旨在增加供体器官使用的潜在肺供体选择、评估和管理方面的最新进展。
严格遵循最初发布的肺移植供体可接受性标准，限制了可用于移植的供体肺数量。旨在增加供体肺利用率的重要进展包括使用心死亡供体肺、减体积肺和扩展标准肺。预测供体肺移植后功能的新兴诊断工具可能会在未来显著促进合适供体肺的选择。
通过积极的供体管理和考虑完整的和扩展的供体库，最佳的供体管理应旨在最大程度地增加肺捐献。然而，需要进行长期研究来验证这种方法，并确认使用传统和非传统器官供体不会影响长期结果。
