Analysis of the characteristics of lungs available for transplantation in São Paulo State

Abstract

Objectives: To analyze the utilization rate of lungs available for transplantation in São Paulo State during 2006, as well as to determine the lung donor profile in this same period. Methods: Retrospective study of 497 lung-donor’s medical records during jan/2006 todec/2006. Results: An amount of 149 (30%) of the 497 general donors analyzed did not havetheir lungs offered to transplant and thus were precluded from the study. From the remaining 348 lung donors, 56.9% were man, with mean age of 37.4±16.1 years. The main donor death causes were: stroke (40.5%), cranial trauma (34.2%) and subarachnoid haemorrhages (10.9%). Most of these lung-donors received vasoactive agents (90.5%) and 13.5% had cardiopulmonary arrest. Considering the infectious aspects, the mean leukocyte count was 15,008 ± 6,467/mm3, 67.8% received anti-bacterial agents and 26.1% presented lung infection. Almost 40% of the lung-donors presented radiographic alterations. Only 4.9% of the lung-donors were accepted, representing 28 lungs (allograft utilization rate equivalent to 4.0%). The main reasons for precluding donors were: gas-exchange alterations (30.1%), infection (23.7%) and distance (10.9%). Conclusions: The lung utilization rate in São Paulo State can be considered low when compared to the best global models of tissue and organ procurement. Futher more, more than 50% of the precluding reasons were improper gas-exchange and presence of infection. Combining better health care to the potential donor with the liberalization of lung-donor criteria could increase the allograft utilization rate.