BACKGROUND A donor arterial PO2/FiO2 (P/F ratio) of less than the 300 threshold would frequently result in either exclusion of the donor or placement of the lungs on ex vivo lung perfusion (EVLP). The aim was to investigate the veracity of the P/F ratio threshold of 300 for donor lung acceptability. METHODS In 93 brain dead lung donors, arterial blood gases were drawn in the intensive care unit (ICU) just before procurement and each of the 4 donor pulmonary veins in the operating room (OR). No donor lungs were rejected for transplantation based on the last ICU or OR P/F ratio, and EVLP was not used. The recipients were followed up 6 and 12 months following transplantation. RESULTS There were 93 recipients of bilateral lung transplantation. An arterial P/F ratio of < 300 was largely driven by a low P/F ratio in the lower lobes. There were no differences between the recipients receiving donor lungs where the ICU P/F ratio was < 300 compared with ≥ 300 in the time to extubation, grade of primary graft dysfunction, pulmonary function at 6 and 12 months, and 12-month survival. CONCLUSIONS From this study:(1) If a donor P/F threshold of 300 was adhered to, 36% would have been rejected, and (2) The donor P/F ratio threshold of 300 is excessively conservative and results in the wastage of donor lungs and the application of unnecessary EVLP.

中文翻译：

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<300 mm Hg的供体PaO2 / FiO2不能确定肺移植后的移植功能或存活率。

背景技术小于300阈值的供体动脉PO2 / FiO2（P / F比）将经常导致排斥供体或在离体肺灌注（EVLP）上放置肺。目的是研究供体肺可接受性的P / F比阈值300的准确性。方法在93名脑死亡的肺供体中，就在购置前在重症监护病房（ICU）中抽取了动脉血气，并在手术室（OR）中抽取了4条供体肺静脉中的每条。根据最后的ICU或OR P / F比，没有任何供体肺被拒绝移植，并且不使用EVLP。移植后6个月和12个月对接受者进行了随访。结果有93例双侧肺移植受者。<300的动脉P / F比很大程度上是由下叶的低P / F比驱动的。ICU P / F比<300，而拔管时间，原发性移植物功能障碍的等级，6和12个月的肺功能以及12个月的存活率，ICU P / F比<300的接受者之间没有差异。结论：（1）如果遵守捐赠者P / F阈值300，则将有36％被拒绝；（2）捐赠者P / F阈值300过于保守，导致浪费。供体肺和不必要的EVLP的应用。