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First Recipient of Deceased Donor's Lung Dies

WebMD Health News

March 20, 2001 -- The Swedish patient who was the first to receive a deceased donor's lung has died from complications of another organ transplant.


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 families.


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.

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