Lung transplantation from polytrauma donors: beyond primary graft dysfunction
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By
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Chiara Catelli
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Daniele Marianello
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Andrea Lloret Madrid
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Marianna Rizzo
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Miriana D'Alessandro
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Margherita Sambo
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Francesca Montagnani
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Marco Guerrieri
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David Bennett
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Elena Bargagli
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Piero Paladini
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Federico Franchi
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Luca Luzzi
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June 19, 2026
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Clinical Scorecard: Lung Transplantation Utilizing Polytrauma Donors: Evaluating Outcomes Beyond Initial Graft Dysfunction
At a Glance
| Category | Detail |
|---|
| Condition | Lung Transplantation |
| Key Mechanisms | Evaluation of early and mid-term outcomes after lung transplantation using lungs from polytrauma donors compared with non-polytrauma donors. |
| Target Population | Lung transplant recipients from brain-dead donors. |
| Care Setting | Thoracic Surgery and Lung Transplant Unit of the Siena University Hospital |
Key Highlights
- Polytrauma donors are typically younger and have fewer comorbidities.
- No significant differences in survival or pulmonary function after propensity score matching.
- Overall survival at 6 months was higher in the polytrauma donor group (91.7% vs. 75.3%).
- Early postoperative outcomes were comparable between polytrauma and non-polytrauma donor groups.
- Lungs from polytrauma donors can yield outcomes comparable to non-trauma donors.
Guideline-Based Recommendations
Diagnosis
- Evaluate donor characteristics including age, cause of death, and pulmonary contusions.
Management
- Consider the safe and selective use of lungs from polytrauma donors to expand the donor pool.
Monitoring & Follow-up
- Monitor for primary graft dysfunction and pulmonary function post-transplant.
Risks
- Potential for primary graft dysfunction due to trauma-related lung injury.
Patient & Prescribing Data
Lung transplant recipients from brain-dead donors.
Outcomes from polytrauma donors are comparable to non-polytrauma donors after adjustment for baseline differences.
Clinical Best Practices
- Utilize a propensity score matching approach to account for baseline differences in donor characteristics.
- Exclude recipients who received lungs from donors after circulatory death to minimize bias.
- Assess the presence of pulmonary contusions in donor evaluation.
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