Donor organ shortage results in significant waiting list mortality. Donor lung assessment is currently based on donors' history, gas exchange, chest X-ray, bronchoscopy findings, and ultimately in situ inspection but remains subjective. We correlated histopathology and radiology in nontransplanted donor lungs with the clinical indications to decline the offered organ. Sixty-two donor lungs, not used for transplantation (2010-2019), were procured, air-inflated, frozen, scanned with computed tomography, systematically sampled, and histologically and radiologically assessed. Thirty-nine (63%) lungs were declined for allograft-related reasons. In 13/39 (33%) lungs, histology could not confirm the reason for decline, in an additional 8/39 (21%) lungs, histologic abnormalities were only considered mild. In 16/39 (41%) lungs, radiology could not confirm the reason for decline. Twenty-three (37%) donor lungs were not transplanted due to extrapulmonary causes, of which three (13%) lungs displayed severe histologic abnormalities (pneumonia, n = 2; emphysema, n = 1), in addition to mild emphysema in 9 (39%) lungs and minor bronchopneumonia in 1 (4%). Radiology revealed ground-glass opacities in 8/23 (35%) and emphysema in 4/23 (17%) lungs. Histopathologic and radiologic assessment of nontransplanted donor lungs revealed substantial discrepancy with the clinical reason for decline. Optimization of donor lung assessment is necessary to improve current organ acceptance rates.

中文翻译：

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非移植供体肺的组织病理学和放射学评估。

供体器官短缺导致显着的等待名单死亡率。供体肺评估目前基于供体的病史、气体交换、胸部 X 光检查、支气管镜检查结果以及最终的原位检查，但仍然是主观的。我们将非移植供体肺的组织病理学和放射学与拒绝提供器官的临床指征相关联。采购了 62 个未用于移植的供体肺（2010-2019 年）、充气、冷冻、计算机断层扫描、系统取样以及组织学和放射学评估。39 个 (63%) 肺因同种异体移植相关原因而被拒绝。在 13/39 (33%) 个肺中，组织学无法确定下降的原因，在另外 8/39 (21%) 个肺中，组织学异常仅被认为是轻微的。在 16/39 (41%) 个肺中，放射科无法确认下降的原因。23 个 (37%) 供肺因肺外原因未移植，其中 3 个 (13%) 肺显示出严重的组织学异常（肺炎，n = 2；肺气肿，n = 1），另外 9 个肺有轻度肺气肿(39%) 肺部和轻微支气管肺炎 1 (4%)。放射学显示 8/23 (35%) 肺部有磨玻璃影，4/23 (17%) 肺部有肺气肿。非移植供体肺的组织病理学和放射学评估显示，与下降的临床原因存在显着差异。优化供体肺评估对于提高当前的器官接受率是必要的。肺气肿，n = 1)，此外还有 9 例 (39%) 轻度肺气肿和 1 例 (4%) 轻度支气管肺炎。放射学显示 8/23 (35%) 肺部有磨玻璃影，4/23 (17%) 肺部有肺气肿。非移植供体肺的组织病理学和放射学评估显示，与下降的临床原因存在显着差异。优化供体肺评估对于提高当前的器官接受率是必要的。肺气肿，n = 1)，此外还有 9 例 (39%) 轻度肺气肿和 1 例 (4%) 轻度支气管肺炎。放射学显示 8/23 (35%) 肺部有磨玻璃影，4/23 (17%) 肺部有肺气肿。非移植供体肺的组织病理学和放射学评估显示，与下降的临床原因存在显着差异。优化供体肺评估对于提高当前的器官接受率是必要的。