{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:53:51Z","timestamp":1781844831310,"version":"3.54.5"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lung donors are increasingly older and marginal. Polytrauma donors (PD) represent a potentially valuable resource due to their younger age, although trauma-related lung injury raises concerns regarding graft quality. This study aimed to evaluate early and mid-term outcomes after lung transplantation using lungs from PDs compared with non-polytrauma donors (NPD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 125 lung transplant recipients from brain-dead donors between January 2013 and June 2024. Perioperative outcomes, primary graft dysfunction (PGD), and pulmonary function at 1, 3, and 6 months were compared between PD (\n                      <jats:italic>n<\/jats:italic>\n                      = 36) and NPD (\n                      <jats:italic>n<\/jats:italic>\n                      = 89) groups. To account for baseline differences, a 1:1 propensity score matching (PSM) was performed based on donor age, recipient age, and ischemic time.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the overall cohort, PDs were younger and more frequently male, with a higher prevalence of pulmonary contusions. Early postoperative outcomes, including PGD, ICU stay, and perioperative complications, were comparable between groups. At 6 months, overall survival was higher in the PD group (91.7 vs. 75.3%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.048). After PSM, no significant differences were observed in survival (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.66), perioperative outcomes, or pulmonary function. Functional recovery and CLAD rates were similar between groups across all time points.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Lung transplantation using grafts from polytrauma donors is not associated with worse perioperative or mid-term outcomes. After adjustment for baseline differences, outcomes were comparable to those from non-polytrauma donors, supporting the safe and selective use of these grafts as a strategy to expand the donor pool.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1851797","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:29:51Z","timestamp":1781843391000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lung transplantation from polytrauma donors: beyond primary graft dysfunction"],"prefix":"10.3389","volume":"13","author":[{"given":"Chiara","family":"Catelli","sequence":"first","affiliation":[{"name":"Thoracic Surgery and Lung Transplant Unit, Department of Medicine, Surgery and Neurosciences, University of Siena","place":["Siena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Marianello","sequence":"additional","affiliation":[{"name":"Cardiothoracic and Vascular Anesthesia and Intensive Care Unit, Department of Medicine, Surgery and Neurosciences, University of Siena","place":["Siena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lloret Madrid","sequence":"additional","affiliation":[{"name":"Thoracic Surgery and Lung Transplant Unit, Department of Medicine, Surgery and Neurosciences, University of Siena","place":["Siena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Thoracic Surgery and Lung Transplant Unit, Department of Medicine, Surgery and Neurosciences, University of Siena","place":["Siena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriana","family":"D'Alessandro","sequence":"additional","affiliation":[{"name":"Department of Life Sciences, Health and Healthcare Professions, Link Campus University","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Sambo","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Diseases Unit, Department of Medical Biotechnologies, University of Siena","place":["Siena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Montagnani","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Diseases Unit, Department of Medical Biotechnologies, University of Siena","place":["Siena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Guerrieri","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena","place":["Siena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Bennett","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena","place":["Siena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Bargagli","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena","place":["Siena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Paladini","sequence":"additional","affiliation":[{"name":"Thoracic Surgery and Lung Transplant Unit, Department of Medicine, Surgery and Neurosciences, University of Siena","place":["Siena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Franchi","sequence":"additional","affiliation":[{"name":"Cardiothoracic and Vascular Anesthesia and Intensive Care Unit, Department of Medicine, Surgery and Neurosciences, University of Siena","place":["Siena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Luzzi","sequence":"additional","affiliation":[{"name":"Thoracic Surgery and Lung Transplant Unit, Department of Medicine, Surgery and Neurosciences, University of Siena","place":["Siena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"B1","first-page":"421","article-title":"Expanded criteria donors","author":"Cho","year":"1998","journal-title":"Clin Transplan."},{"key":"B2","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1097\/TA.0000000000002322","article-title":"Organ donation after trauma: A 30-year review","volume":"87","author":"Ackerman","year":"2019","journal-title":"J. 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