Rejected lungs found suitable for transplant
It may be time to reconsider the criteria.
By
Andis Robeznieks, AMNews staff. Oct. 21, 2002.
Additional information
New research indicates that many lungs rejected for transplant may
actually be suitable for use and that up to 1,000 lives each year could be
saved by "liberalizing" transplant criteria.
More than 85% of donor lungs are rejected for transplant, but a new
study published in The Lancet provides evidence that many of these
organs could have been used.
Researchers found that 41% of 29 pairs of donated lungs examined and
rejected by the California Transplant Donor Network would have been
"potentially suitable" for transplantation.
"This adds further emphasis for the need to re-evaluate transplant
criteria," said senior report author Michael A. Matthay, MD, an internist
from the University of California San Francisco Medical Center. "I don't
think that, on the basis of one observation like ours, everybody is going
to change their criteria, but I think it will have serious impact because
it will push the point further that there needs to be more studies on
liberalizing the criteria."
Dr. Matthay said this study complements a 1999 Australian study, in
which researchers found that there was little difference in the survival
rates between patients receiving so-called "ideal" lungs and those
receiving "marginal" lungs.
The problem, he said, is that lung transplant criteria have arbitrarily
evolved without necessarily being founded on hard evidence.
"Partly by default, surgeons and transplant physicians have gone along
with the idea that, if the x-ray shows a mild abnormality, or if the
patient was a little older -- say 58 to 61 -- or was a moderate smoker,
that patient's lungs should not be used," Dr. Matthay said. "The criteria
of the past might be too strict, so it's probably time to re-evaluate
them."
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