Low-risk donor lungs optimize the post-lung transplant outcome for high lung allocation score patients

Takeshi Kurosaki, Kentaroh Miyoshi, Shinji Otani, Kentaro Imanishi, Seiichiro Sugimoto, Masaomi Yamane, Motomu Kobayashi, Shinichi Toyooka, Takahiro Oto

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Purpose: The lung allocation score (LAS) has been generally recognized as a contributor to the overall survival in lung transplant candidates. However, donor-related risks have never been taken into consideration in previous research that validated the LAS. This study aimed to determine whether or not the role of the LAS as a predictor of the posttransplant outcome is influenced by the quality of the donor lungs. Methods: We retrospectively reviewed 108 patients who underwent lung transplantation at Okayama University Hospital since 1998. The cohort was divided into two groups based on the lung donor score (DS; ≤ 4/> 4). Correlations between the LAS and posttransplant outcomes were investigated in both groups. Results: In the high-DS group, an elevated LAS was strongly associated with posttransplant PaO 2 /FiO 2 (p = 0.018). However, in the low-DS group, no correlation was found between them. There was no significant difference in the long-term survival according to the LAS in the low-DS group. The LAS effectively predicted the posttransplant outcome only when lungs with DS > 4 were transplanted; the LAS was not reliable if high-quality lungs were transplanted. Conclusion: Lung transplantation can be feasible and provides a survival benefit even for high-LAS patients if lungs from a low-risk donor are transplanted.

Original languageEnglish
Pages (from-to)928-935
Number of pages8
JournalSurgery today
Issue number10
Publication statusPublished - Oct 1 2018


  • Donor score
  • Low-risk donor
  • Lung allocation score
  • Lung transplantation

ASJC Scopus subject areas

  • Surgery


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