Carli J. Lehr, M.D., from the Cleveland Clinic, and colleagues studied the impact of the U.S. Public Health Service broadened definition of increased-risk donors (IRD; January 2014 through May 2017) versus high-risk donors (HRD; January 2006 to October 2013) and donors at standard infectious risk on lung transplant recipient outcomes.
The researchers identified 18,490 lung transplant recipients, 36 percent of whom received lungs during the IRD definition period.The change in definition resulted in an increase in the proportion of donors classified as having nonstandard infection risk. Specifically, 8% of donors were classified as HRD, while 22% were in the IRD category (P < 0.001). Despite this change in classification, the study found no significant differences in outcomes for lung transplant recipients from IRD and HRD donors in terms of survival, complications, and graft rejection rates.
“Our findings raise the question of the utility of the designation of ‘increased risk’ for donor lungs, since there is no impact on outcomes,” Lehr said in a statement. “Forgoing the designation, treating all donors as potentially at risk, and using appropriate posttransplant screening for infectious diseases may increase overall organ utilization and lessen deaths on the waitlist.”
