P-POD

What is P-POD?

The P-POD study is a pilot randomized controlled trial designed to test whether placing neurologically deceased organ donors in the prone position can improve donor lung function and potentially increase the number of lungs suitable for transplantation. Prone positioning may reduce lung injury, improve oxygenation, and decrease inflammation, leading to better transplant outcomes. The study involves applying a structured prone-positioning protocol, maintaining protective mechanical ventilation, monitoring for feasibility metrics and collecting detailed donor and recipient outcome data.

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Why is this important?

Donor lungs are frequently lost due to injury, inflammation, or poor oxygenation following neurological death. Current donor lung utilization rates remain low—only 15–30% of donated lungs are ultimately transplanted. Prone positioning has been shown in clinical and pre-clinical research to improve oxygenation, reduce atelectasis, and mitigate ventilator-induced lung injury. If effective and feasible, the P-POD approach could significantly expand the lung donor pool and improve outcomes for lung transplant recipients.

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What is involved in the study?

The study enrolls 40 neurologically deceased potential lung donors, who are randomized to either prone or supine positioning while receiving the same protective mechanical ventilation strategy. Donors in the prone arm remain prone for ≥16 hours/day until organ procurement. Data collected include ventilator parameters, blood gases, biochemistry, biomarkers, and adverse events. Recipients of study lungs are followed for early post‑transplant outcomes, including graft function, organ support needs, and survival up to 90 days. Feasibility is measured by donor accrual, protocol adherence, and frequency of crossover between arms.