This study assessed whether chest computed tomography (CT) findings improve the validated Lung Donor (LUNDON) score for predicting acceptance of brain-dead donor lungs. Among 2,454 donors who underwent CT, emphysema, pulmonary oedema, and traumatic lung injury reduced the likelihood of lung acceptance. However, replacing the original chest-radiograph variable with a weighted CT composite score—or adding CT to radiography—did not meaningfully improve discrimination (C-statistics 0.887 and 0.890 vs 0.883); all model versions predicted one-year graft survival.
For CTSNet’s global transplant audience, the findings show that while CT provides clinically useful anatomical detail, it may not substantially outperform an established, simpler, radiograph-based donor-assessment tool. Nevertheless, standardized capture of donor CT findings could enable more consistent organ assessment, refine future prediction models, and potentially support the safe expansion of the donor-lung pool.
