Table 12.4. Traditional criteria for donor lung suitability

Preliminary Assessment

• ABO compatibility

• Chest radiograph: clear, allows estimate of size match

- Smoking <20 pack-years

- No significant chest trauma

- No aspiration, sepsis

- Gram stain and culture data if prolonged intubation

- No prior cardiac/pulmonary operation

• Oxygenation

• Adequate size matching Final Assessment

• Chest radiograph shows no unfavorable changes

• Oxygenation has not deteriorated

• Bronchoscopy shows no purulent secretions, aspiration

• Visual/manual assessment

- Parenchyma is satisfactory

- No masses

Before lung transplantation became commonplace, large volumes of fluid were used to maintain mean arterial blood pressure in multiple organ donors, to maintain urine output in kidney donors, to avoid inotropes in heart donors, and to avoid the use of vasopressin in liver donors. This volume overload can lead to pulmonary edema, thereby compromising the pulmonary allografts. General guidelines for managing the multiple organ donors are shown in Table 12.5. These guidelines should be followed in close cooperation with the other organ procurement teams.

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