Single-lung transplantation with ABO-compatible donors results in excellent outcomes

Sharven Taghavi; Senthil N. Jayarajan; Yuka Furuya; Eugene Komaroff; Akira Shiose; Eros Leotta; Kazuhiro Hisamoto; Namrata Patel; Francis Cordova; Gerard Criner; T. Sloane Guy; Yoshiya Toyoda

doi:10.1016/j.healun.2014.04.006

Single-lung transplantation with ABO-compatible donors results in excellent outcomes

Sharven Taghavi, Senthil N. Jayarajan, Yuka Furuya, Eugene Komaroff, Akira Shiose, Eros Leotta, Kazuhiro Hisamoto, Namrata Patel, Francis Cordova, Gerard Criner, T. Sloane Guy, Yoshiya Toyoda

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Background The goal of this study was to determine if carefully selected ABO-compatible donors in single-lung transplantation results in acceptable outcomes. Methods The United Network for Organ Sharing database was reviewed for adult single-lung transplant recipients from May 2005 to December 2011. Recipients of lungs from ABO-compatible donors were compared with those of ABO-identical donors. Mortality was examined with risk-adjusted multivariable Cox proportional hazards regression using significant univariate predictors. Results Of 3,572 single-lung transplants, 342 (9.6%) were from ABO-compatible donors. The two groups were evenly matched in recipient age (60.8 vs 60.2 years, p = 0.28), male gender (61.8% vs 58.2%, p = 0.10), lung allocation score (43.4 vs 42.6, p = 0.32), forced expiratory volume in 1 second (FEV₁; 41.2% vs 40.8%, p = 0.32), and ischemic time (4.2 vs 4.0 hours, p = 0.09), and donor age (34.4 vs 32.9, p = 0.07) and male gender (61.5 vs 65.5, p = 0.14). ABO-compatible donors were less likely to be race mismatched (58.3% vs 50.9%, p = 0.01). Median survival was not different (1,284.0 vs 1,540 days, p = 0.39). On multivariate analysis, lungs from ABO-compatible donors were not associated with mortality (hazard ratio, 1.02; 95% confidence interval, 0.85-1.22; p = 0.86). Prolonged ischemic time, increasing recipient creatinine, increasing recipient age, race mismatch, class I plasma reactive antigen panel > 10%, and the use of mechanical ventilation or extracorporeal membrane oxygenation were associated with mortality. Peak post-transplant FEV₁ (64.5% vs 64.0%, p = 0.69) and decrement in FEV₁ over time were similar (p = 0.82). Conclusions This large multi-institutional analysis of ABO-compatible donors in single-lung transplantation demonstrates that careful selection of ABO-compatible donors results in excellent outcomes.

Original language	English (US)
Pages (from-to)	822-828
Number of pages	7
Journal	Journal of Heart and Lung Transplantation
Volume	33
Issue number	8
DOIs	https://doi.org/10.1016/j.healun.2014.04.006
State	Published - Aug 2014
Externally published	Yes

Bibliographical note

Funding Information:
This work was partly supported by the Health Resources and Services Administration (Contract 234-2005-37011C). The content of this study is the responsibility of the authors alone and does not necessarily reflect the views or policies of the U.S. Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

Keywords

ABO-compatible donors
ABO-identical donors
outcomes
single-lung transplantation

Access

10.1016/j.healun.2014.04.006

OpenUrl availability

Full text

Cite this

@article{ad07d16a3f3049aca14278bce8bfc619,

title = "Single-lung transplantation with ABO-compatible donors results in excellent outcomes",

abstract = "Background The goal of this study was to determine if carefully selected ABO-compatible donors in single-lung transplantation results in acceptable outcomes. Methods The United Network for Organ Sharing database was reviewed for adult single-lung transplant recipients from May 2005 to December 2011. Recipients of lungs from ABO-compatible donors were compared with those of ABO-identical donors. Mortality was examined with risk-adjusted multivariable Cox proportional hazards regression using significant univariate predictors. Results Of 3,572 single-lung transplants, 342 (9.6%) were from ABO-compatible donors. The two groups were evenly matched in recipient age (60.8 vs 60.2 years, p = 0.28), male gender (61.8% vs 58.2%, p = 0.10), lung allocation score (43.4 vs 42.6, p = 0.32), forced expiratory volume in 1 second (FEV1; 41.2% vs 40.8%, p = 0.32), and ischemic time (4.2 vs 4.0 hours, p = 0.09), and donor age (34.4 vs 32.9, p = 0.07) and male gender (61.5 vs 65.5, p = 0.14). ABO-compatible donors were less likely to be race mismatched (58.3% vs 50.9%, p = 0.01). Median survival was not different (1,284.0 vs 1,540 days, p = 0.39). On multivariate analysis, lungs from ABO-compatible donors were not associated with mortality (hazard ratio, 1.02; 95% confidence interval, 0.85-1.22; p = 0.86). Prolonged ischemic time, increasing recipient creatinine, increasing recipient age, race mismatch, class I plasma reactive antigen panel > 10%, and the use of mechanical ventilation or extracorporeal membrane oxygenation were associated with mortality. Peak post-transplant FEV1 (64.5% vs 64.0%, p = 0.69) and decrement in FEV1 over time were similar (p = 0.82). Conclusions This large multi-institutional analysis of ABO-compatible donors in single-lung transplantation demonstrates that careful selection of ABO-compatible donors results in excellent outcomes.",

keywords = "ABO-compatible donors, ABO-identical donors, outcomes, single-lung transplantation",

author = "Sharven Taghavi and Jayarajan, {Senthil N.} and Yuka Furuya and Eugene Komaroff and Akira Shiose and Eros Leotta and Kazuhiro Hisamoto and Namrata Patel and Francis Cordova and Gerard Criner and Guy, {T. Sloane} and Yoshiya Toyoda",

note = "Funding Information: This work was partly supported by the Health Resources and Services Administration (Contract 234-2005-37011C). The content of this study is the responsibility of the authors alone and does not necessarily reflect the views or policies of the U.S. Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. ",

year = "2014",

month = aug,

doi = "10.1016/j.healun.2014.04.006",

language = "English (US)",

volume = "33",

pages = "822--828",

journal = "Journal of Heart and Lung Transplantation",

issn = "1053-2498",

publisher = "Elsevier USA",

number = "8",

}

TY - JOUR

T1 - Single-lung transplantation with ABO-compatible donors results in excellent outcomes

AU - Taghavi, Sharven

AU - Jayarajan, Senthil N.

AU - Furuya, Yuka

AU - Komaroff, Eugene

AU - Shiose, Akira

AU - Leotta, Eros

AU - Hisamoto, Kazuhiro

AU - Patel, Namrata

AU - Cordova, Francis

AU - Criner, Gerard

AU - Guy, T. Sloane

AU - Toyoda, Yoshiya

N1 - Funding Information: This work was partly supported by the Health Resources and Services Administration (Contract 234-2005-37011C). The content of this study is the responsibility of the authors alone and does not necessarily reflect the views or policies of the U.S. Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

PY - 2014/8

Y1 - 2014/8

N2 - Background The goal of this study was to determine if carefully selected ABO-compatible donors in single-lung transplantation results in acceptable outcomes. Methods The United Network for Organ Sharing database was reviewed for adult single-lung transplant recipients from May 2005 to December 2011. Recipients of lungs from ABO-compatible donors were compared with those of ABO-identical donors. Mortality was examined with risk-adjusted multivariable Cox proportional hazards regression using significant univariate predictors. Results Of 3,572 single-lung transplants, 342 (9.6%) were from ABO-compatible donors. The two groups were evenly matched in recipient age (60.8 vs 60.2 years, p = 0.28), male gender (61.8% vs 58.2%, p = 0.10), lung allocation score (43.4 vs 42.6, p = 0.32), forced expiratory volume in 1 second (FEV1; 41.2% vs 40.8%, p = 0.32), and ischemic time (4.2 vs 4.0 hours, p = 0.09), and donor age (34.4 vs 32.9, p = 0.07) and male gender (61.5 vs 65.5, p = 0.14). ABO-compatible donors were less likely to be race mismatched (58.3% vs 50.9%, p = 0.01). Median survival was not different (1,284.0 vs 1,540 days, p = 0.39). On multivariate analysis, lungs from ABO-compatible donors were not associated with mortality (hazard ratio, 1.02; 95% confidence interval, 0.85-1.22; p = 0.86). Prolonged ischemic time, increasing recipient creatinine, increasing recipient age, race mismatch, class I plasma reactive antigen panel > 10%, and the use of mechanical ventilation or extracorporeal membrane oxygenation were associated with mortality. Peak post-transplant FEV1 (64.5% vs 64.0%, p = 0.69) and decrement in FEV1 over time were similar (p = 0.82). Conclusions This large multi-institutional analysis of ABO-compatible donors in single-lung transplantation demonstrates that careful selection of ABO-compatible donors results in excellent outcomes.

AB - Background The goal of this study was to determine if carefully selected ABO-compatible donors in single-lung transplantation results in acceptable outcomes. Methods The United Network for Organ Sharing database was reviewed for adult single-lung transplant recipients from May 2005 to December 2011. Recipients of lungs from ABO-compatible donors were compared with those of ABO-identical donors. Mortality was examined with risk-adjusted multivariable Cox proportional hazards regression using significant univariate predictors. Results Of 3,572 single-lung transplants, 342 (9.6%) were from ABO-compatible donors. The two groups were evenly matched in recipient age (60.8 vs 60.2 years, p = 0.28), male gender (61.8% vs 58.2%, p = 0.10), lung allocation score (43.4 vs 42.6, p = 0.32), forced expiratory volume in 1 second (FEV1; 41.2% vs 40.8%, p = 0.32), and ischemic time (4.2 vs 4.0 hours, p = 0.09), and donor age (34.4 vs 32.9, p = 0.07) and male gender (61.5 vs 65.5, p = 0.14). ABO-compatible donors were less likely to be race mismatched (58.3% vs 50.9%, p = 0.01). Median survival was not different (1,284.0 vs 1,540 days, p = 0.39). On multivariate analysis, lungs from ABO-compatible donors were not associated with mortality (hazard ratio, 1.02; 95% confidence interval, 0.85-1.22; p = 0.86). Prolonged ischemic time, increasing recipient creatinine, increasing recipient age, race mismatch, class I plasma reactive antigen panel > 10%, and the use of mechanical ventilation or extracorporeal membrane oxygenation were associated with mortality. Peak post-transplant FEV1 (64.5% vs 64.0%, p = 0.69) and decrement in FEV1 over time were similar (p = 0.82). Conclusions This large multi-institutional analysis of ABO-compatible donors in single-lung transplantation demonstrates that careful selection of ABO-compatible donors results in excellent outcomes.

KW - ABO-compatible donors

KW - ABO-identical donors

KW - outcomes

KW - single-lung transplantation

UR - http://www.scopus.com/inward/record.url?scp=84905090628&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84905090628&partnerID=8YFLogxK

U2 - 10.1016/j.healun.2014.04.006

DO - 10.1016/j.healun.2014.04.006

M3 - Article

C2 - 24880825

AN - SCOPUS:84905090628

SN - 1053-2498

VL - 33

SP - 822

EP - 828

JO - Journal of Heart and Lung Transplantation

JF - Journal of Heart and Lung Transplantation

IS - 8

ER -

Single-lung transplantation with ABO-compatible donors results in excellent outcomes

Abstract

Bibliographical note

Keywords

Access

OpenUrl availability

Other files and links

Fingerprint

Cite this