Surfactant alterations following donation after cardiac death donor lungs

Summary The use of lungs from donation after cardiac death (DCD) donors is one of the strategies to increase the donor pool. The aim of this study was to assess the surfactant alterations in DCD donor lungs. Pigs were sacrificed and left untouched for 1 (DCD1), 2 (DCD2) and 3 (DCD3) h. Lungs were then topically cooled with saline for 1, 2 or 3 h to reach a total ischemic time of 4 h. Heart‐beating donors (HBD) served as control group. Bronchoalveolar lavage (BAL) samples were assessed for protein levels and surfactant function. Left lungs were prepared for ex‐vivo evaluation. Pulmonary vascular resistance (PVR), oxygenation, airway pressure (AWP) and wet‐to‐dry weight ratio were significantly different between HBD and DCD3 groups (P