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• W2108706857 abstract "The letter of Mohamed, in response to a paper published last year in the Journal of Heart and Lung Transplantation, deals with the possible restriction to the use of donor organs from a lung transplant patient who has died of chronic lung allograft dysfunction (CLAD). In fact, the author assumes that the pro-inflammatory status of CLAD may extend beyond the lungs and may therefore also affect other organs, which may in turn preclude safe organ donation. This may open up an interesting discussion. Although the concept is of interest, it remains up to now a theoretical discussion, because no real data have been published showing that organs from a lung transplant patient with CLAD are unsafe to transplant in another recipient. First, some patients with CLAD hardly have inflammatory cytokines in their lungs, which is strictly dependent on the phenotype of CLAD they develop. Moreover, there is at present no evidence that the inflammatory cytokines that may arise during CLAD and may extend beyond the lungs have an additional negative effect to the cytokine storm that is already present in a potential donor, whether a brain-death or a cardiac-death donor. Indeed, severe brain injury and brain stem death have been associated with increased systemic inflammation and with cytokine activation in peripheral organs. Also, the mode of death before cardiac death may negatively influence the quality of the pulmonary graft. This all means that systemic cytokines already induce inflammation upon retrieval of any organ from any donor. As a consequence, attenuating the donor’s inflammatory response before organ retrieval may improve early outcome after lung transplantation, and that is exactly what is normally done by donor administration of a high dose of intravenous steroids. In our own center, we have experience with 2 patients who previously underwent heart-lung and lung transplantation, respectively, and who became effective organ donors after cerebral death. The first patient received a transplant for Eisenmenger syndrome and was admitted to the intensive care unit 5 months after the procedure because" @default.
• W2108706857 created "2016-06-24" @default.
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• W2108706857 date "2015-08-01" @default.
• W2108706857 modified "2023-09-27" @default.
• W2108706857 title "Chronic lung allograft dysfunction and organ donation: Is it a problem? Response to Mohamed" @default.
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• W2108706857 doi "https://doi.org/10.1016/j.healun.2015.03.018" @default.
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• W2108706857 hasPublicationYear "2015" @default.
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