Objective: To analyse the background of the shortage of donor lungs; to present the procedure of allocation of donor lungs in the Eurotransplant region and the selection of donor lungs in the lung transplantation programme Groningen.
Design: Descriptive.
Setting: Groningen University Hospital.
Methods: From March 23, 1991 to December 31, 1993, the lungs of 279 multi-organ donors were offered to the lung transplantation programme of Groningen University Hospital. The assessment and selection criteria are presented.
Results: Only 35 out of all donor lungs offered could be used for transplantation: 24 double and 11 single lung transplants. Medical contraindications (notably pulmonary injury and hypoxaemia) were present in 155 out of the 244 (64%) lung donors. Forty-five out of 244 (18%) lung donors were rejected for logistic reasons, predominantly too little time between offer and imposed start of the explantation or long travel time.
Conclusion: Lung donor shortage is the main factor limiting the expansion of lung transplantation programmes. Increase of the number of suitable donors can be achieved by improving donor recognition and donor management, and by improving preservation techniques allowing increased acceptable cold ischaemia periods.