Effect of Donor Oxygenation Trajectory on Lung Procurement for Transplantation

In this study of 4,854 brain-dead donors from three U.S. organ procurement organizations, the donor PaO2 trajectory strongly influenced lung procurement: More than 75 percent had low initial PaO2, but those whose oxygenation improved to high final values, aided by bronchoscopy, inotropes, and antibiotics, achieved a 67.9 percent procurement rate. However, lungs with high initial PaO2 often deteriorated and went unprocured, with recipient survival similar regardless of initial donor PaO2, suggesting that active donor management to improve oxygenation could expand the usable lung pool without compromising outcomes.