Outcomes of lung transplantation from organ donation after medical assistance in dying: First North American experience

Tatsuaki Watanabe, Mitsuaki Kawashima, Mikihiro Kohno, Jonathan Yeung, James Downar, Andrew Healey, Tereza Martinu, Meghan Aversa, Laura Donahoe, Andrew Pierre, Marc de Perrot, Kazuhiro Yasufuku, Thomas K. Waddell, Shaf Keshavjee, Marcelo Cypel

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Over 2.5% of deaths in Canada occur as a result from medical assisting in dying (MAID), and a subset of these deaths result in organ donation. However, detailed outcomes of lung transplant recipients using these donors is lacking. This is a retrospective single center cohort study comparing lung transplantation outcomes after donation using MAID donors compared to neurologically determined death and controlled donation after circulatory death (NDD/cDCD) donors from February 2018 to July 2021. Thirty-three patients received lungs from MAID donors, and 560 patients received lungs from NDD/cDCD donors. The donor diagnoses leading to MAID provision were degenerative neurological diseases (n = 33) and end stage organ failure (n = 5). MAID donors were significantly older than NDD/cDCD donors (56 [IQR 49–64] years vs. 48 [32–59]; p =.0009). Median ventilation period and 30 day mortality were not significantly different between MAID and NDD/cDCD lungs recipients (ventilation: 1 day [1–3] vs 2 days [1–3]; p =.37, deaths 0% [0/33] vs. 2% [11/560], p =.99 respectively). Intermediate-term outcomes were also similar. In summary, for lung transplantation using donors after MAID, recipient outcomes were excellent. Therefore, where this practice is permitted, donation after MAID should be strongly considered for lung transplantation as a way to respect donor wishes while substantially improving outcomes for recipients with end-stage lung disease. (Figure presented.).

Original languageEnglish
Pages (from-to)1637-1645
Number of pages9
JournalAmerican Journal of Transplantation
Issue number6
Publication statusPublished - 2022 Jun


  • clinical research/practice
  • donors and donation
  • donors and donation: donation after circulatory death (DCD)
  • donors and donation: extended criteria
  • lung transplantation/pulmonology
  • organ procurement
  • organ transplantation in general

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


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