{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T08:12:12Z","timestamp":1778832732672,"version":"3.51.4"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>With persistent donor shortages limiting lung transplantation (LT), optimizing the use of extended-criteria donors is essential. Asphyxiation (AXP) and donation after circulatory death (DCD) donors both experience hypoxic\u2013ischaemic injury, raising concern for graft performance. We evaluated the long-term outcomes of AXP donor LT and the effect of ex vivo lung perfusion (EVLP) on survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult recipients (\u226518 years) of primary LT (2014-2024) in the United Network for Organ Sharing registry were stratified by donor cause of death: AXP vs non-AXP. Survival was estimated by Kaplan\u2013Meier analysis, and multivariable Cox regression identified factors associated with mortality. Subgroup analyses examined EVLP and DCD vs donation after brain death (DBD) cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 26\u2009334 LT recipients, 1406 (5.3%) received AXP donor lungs. Asphyxiation donors were more frequently DCD (9.5% vs 6%, P\u2009&amp;lt;\u2009.001). Ten-year recipient (25.2% vs 27.4%; P\u2009=\u2009.67) and graft (24.1% vs 26.8%; P\u2009=\u2009.72) survival were comparable, and AXP status was not independently associated with mortality after adjusting for allocation era (HR 1.01, 95% CI, 0.91-1.11, P\u2009=\u2009.908). However, EVLP use in AXP lungs correlated with decreased 3-year survival (55.3% vs 74.1%; P\u2009=\u2009.035). Sensitivity analyses demonstrated significant differences among the 4 donor subgroups (DCD-AXP, DCD non-AXP, DBD-AXP, and DBD non-AXP) on overall comparison (P\u2009=\u2009.008), with DCD-AXP recipients exhibiting numerically the highest 5-year survival rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AXP donor lungs provide comparable long-term outcomes, and DCD-AXP grafts do not appear to confer inferior survival. The interaction between AXP and EVLP use warrants further study to refine donor reconditioning strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/icvts\/ivag108","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T11:49:28Z","timestamp":1775735368000},"source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of Lung Transplantation From Asphyxiation Donors: Reassessing Hypoxic Injury and Implications for Donation After Circulatory Death"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4556-1931","authenticated-orcid":false,"given":"Ye In Christopher","family":"Kwon","sequence":"first","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery, Pauley Heart Center, Virginia Commonwealth University School of Medicine , Richmond, VA, 23298,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Ambrosio","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery, Pauley Heart Center, Virginia Commonwealth University School of Medicine , Richmond, VA, 23298,","place":["United States"]},{"name":"Department of Biostatistics, Virginia Commonwealth University School of Population Health , Richmond, VA, 23298,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Keller","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery, Pauley Heart Center, Virginia Commonwealth University School of Medicine , Richmond, VA, 23298,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chadi A","family":"Hage","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Pittsburgh Medical Center , Pittsburgh, PA, 15213,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Baylor University Medical Center , Dallas, TX, 75246,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suresh","family":"Keshavamurthy","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center , Dallas, TX, 75390,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vipul","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine , Richmond, VA, 23298,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachit D","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery, Pauley Heart Center, Virginia Commonwealth University School of Medicine , Richmond, VA, 23298,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vigneshwar","family":"Kasirajan","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery, Pauley Heart Center, Virginia Commonwealth University School of Medicine , Richmond, VA, 23298,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zubair A","family":"Hashmi","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery, Pauley Heart Center, Virginia Commonwealth University School of Medicine , Richmond, VA, 23298,","place":["United 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