Efficacy of recruitment maneuver for improving the brain dead marginal lungs to ideal

S. Parto, S. Shafaghi, H. R. Khoddami-Vishteh, S. Mohammad Makki, A. Abbasidezfuli, A. Daneshvar, K. Sheikhy, J. Faeghi, F. Ghorbani, T. Parsa, K. Najafizadeh

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Background Because of the shortage of lungs for transplantation, finding the suitable lungs in brain-dead donors is an important issue. Recruitment maneuver is a strategy aimed at re-expanding collapsed and edematous lung tissue. The aim of this study was to assess the efficacy of this maneuver on improving marginal lungs for transplantation. Methods From 127 brain-dead potential donor which were evaluated for lung donation in Masih Daneshvari Organ Procurement Unit of Tehran, Iran, 31 (25%) had marginal lungs for transplantation. These donors had normal chest X ray or bilateral infiltration and had PaO2 200-300 mm Hg with FIO2 100%. The recruitment maneuver was performed and arterial blood gas was obtained before and after maneuver. The maneuver lasts for 2 hours with continuous check of O2 saturation and patient's hemodynamic during. Finally, patients with normal bronchoscopy and PaO2/FIO2 >300 mm Hg were considered good candidates for lung transplantation. The frequency (%) and mean ± SD were used for description of variables and the Wilcoxon test was used for comparison between pre- and post-maneuver PaO2 with FIO2 100%. Results The mean ± SD of PaO2/FIO2 with 100% FIO2 of patients before and after recruitment were 239 ± 62 and 269 ± 91, respectively. Recruitment maneuver could convert 10 marginal lungs (32%) to appropriate ones (PaO2 > 300) and finally 8 lungs were transplanted. Conclusions Findings of this study showed that recruitment maneuver could convert inappropriate lungs to appropriate ones in one third of brain-dead patients who had marginal lung condition. So, it is recommended that this maneuver is considered in the assessment protocol of lungs for donation.

Original languageEnglish (US)
Pages (from-to)3531-3533
Number of pages3
JournalTransplantation Proceedings
Issue number10
StatePublished - Dec 1 2013
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Transplantation

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    Parto, S., Shafaghi, S., Khoddami-Vishteh, H. R., Makki, S. M., Abbasidezfuli, A., Daneshvar, A., Sheikhy, K., Faeghi, J., Ghorbani, F., Parsa, T., & Najafizadeh, K. (2013). Efficacy of recruitment maneuver for improving the brain dead marginal lungs to ideal. Transplantation Proceedings, 45(10), 3531-3533. https://doi.org/10.1016/j.transproceed.2013.09.001