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Lung transplantation: Deceased donor evaluation

Edward R Garrity, MD, MBA
Remzi Bag, MD
Section Editor
Elbert P Trulock, MD
Deputy Editor
Helen Hollingsworth, MD


Optimal selection and care of donor lungs for transplant are needed to increase the number of available lungs. Deceased donor evaluation, selection, and management after brain and cardiac death will be reviewed here from the lung transplant perspective. Living donor lobar transplants are rare in comparison to deceased donor lung transplants.

The indications for lung transplantation, selection of lung transplant recipients, and donor lung preservation are discussed separately. (See "Lung transplantation: An overview" and "Lung transplantation: General guidelines for recipient selection" and "Lung transplantation: Donor lung preservation" and "Management of the deceased organ donor".)


Donor evaluation begins with the notification of the local organ procurement organization (OPO) of a potential donor. A member of the OPO, or a provider trained in the consent of families for organ donation, should approach the family as soon as reasonable after the determination of brain death [1]. (See "Diagnosis of brain death".)

When the patient has signed an irrevocable consent for transplant (offered through some state registries), the OPO staff will support the family through the organ retrieval and grieving process. If consent has not already been provided by the patient, the OPO staff will explain the procurement process to the family, including the dignity of the process and implications for funeral arrangements, and obtain their consent [2]. The OPO staff will also coordinate evaluation of the donor for suitability for transplant and will communicate with the United Network for Organ Sharing (UNOS) to match the donor with an appropriate recipient from the waiting list. (See "Lung transplantation: An overview".)


Some experts recommend that the phrase "donation after circulatory determination of death" (DCDD) replace "donation after cardiac death" or "nonbeating heart donation." These experts emphasize that organ donation occurs after cessation of circulatory and respiratory, not cardiac, function [3]. There is no official consensus to change this terminology, however.

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Literature review current through: Nov 2017. | This topic last updated: Nov 27, 2017.
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