First Recipient of Deceased Donor's Lung Dies
March 20, 2001 -- The Swedish patient who was the first to
receive a deceased donor's lung has died from complications of another organ
The woman, who was 54, died Sunday from a
cytomegalovirus infection, according to doctors from the University of
Lund in Sweden speaking to The Associated Press.
The patient seemed to be doing well after the lung procedure.
But the doctors noted that she went on to get a new liver in order to treat a
condition unrelated to her lung surgery. Then she developed the infection.
Despite the death of this patient, the doctors said they would
continue to test the new lung transplantation procedure and had clearance to
perform eight more.
The Swedish researchers say they have shown that the procedure
is effective and can quickly restore lung function. Because the technique uses
the lungs of a deceased donor, this procedure could help ease the critical
shortage of donor organs worldwide.
Experts note, however, the needs of potential transplant
recipients must be balanced against the rights of potential donors and their
In the U.S. and many other countries, the hearts of organ
donors usually are kept pumping through artificial means after the patient has
been declared brain dead, that is, after all brain activity has irreversibly
ceased. This is necessary to keep blood (and thus oxygen) flowing through the
organs -- kidney, heart, liver, etc. -- before donation. Lungs, however, are
unique in that they can be cooled and preserved for up to 12 hours after the
heart has stopped beating.
Despite vast improvements in organ preservation and transplant
techniques, however, the demand for donor organs still far outpaces the supply.
In Sweden, for example, 20% of patients on the waiting list for a lung
transplant die before an organ becomes available, says lead author Stig Steen,
professor of cardiothoracic surgery at the University of Lund.
But if a method could be found for obtaining lungs from the
bodies of people who died from heart disease in addition to those who were
maintained on mechanical support after brain death, "there would be many
more lungs [available] than there are patients, because on the one hand there
are only 100 cases of brain death in Sweden each year, but 90,000 die due to
cardiovascular disease. So many thousands of lungs could become available,"
Steen tells WebMD.
Steen and his colleagues have developed just such a method,
which involves cooling the lungs within the body about one hour after the donor
has died. But because the procedure involves delivering a clot-preventing drug
to the body immediately after the patient has died, possibly before the
next-of-kin have granted formal consent for organ donation, it raises a host of
ethical concerns that need to be addressed by society at large, says Martin
Elliott, MD. Elliott, a consultant cardiothoracic surgeon and director of
cardiothoracic transplantation at Great Ormond Street Hospital for Children in
London, wrote an editorial accompanying the study.