Examining ABO compatible donors in double lung transplants during the era of lung allocation score

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 journalArticle

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Abstract

Background. The short-term and long-term effect ofusing ABO compatible donors in the era of lung allocationscore is unknown. This study determined if carefullyselected ABO compatible donors could be used in doublelung transplantation (DLT) with good outcomes.

Methods. The United Network for Organ Sharingdatabase was retrospectively reviewed for adult DLTfrom May 2005 to December 2011.

Results. Of 6,655 double lung transplants, 493 (7.4%)were with ABO compatible donors and 6,162 (92.6%) werewith ABO identical donors. In multivariate analysis, use ofABO compatible donors was not associated with mortalityat 30 days (HR, 1.16; 95% CI, 0.76 to 1.79, p [ 0.49), 1 year(HR, 1.10; 95% CI, 0.86 to 1.42, p [ 0.46), and 5 years (HR,1.06; 95% CI, 0.83 to 1.34, p [ 0.65). Variables associatedwith mortality at 5 years were donor female sex, donor age60 years or greater, prolonged ischemic time, increasingrecipient creatinine, recipient age, race mismatch, andmechanical ventilation or extracorporeal membraneoxygenation as a bridge to transplantation. Length of staywas longer in the ABO compatible group (30.9 vs 25.9 days,p [ 0.001). Acute rejection episodes on index hospitalization(8.8 vs. 8.9%, p [ 1.00), peak posttransplant forcedexpiratory volume in 1 second (FEV1) (82.7 vs 79.7%,p [ 0.053), and decrement in FEV1 over time were notdifferent (p[0.13). Freedomfrombronchiolitis obliteranssyndrome was similar (1,475 vs 1,454 days, p[0.17).

Conclusions. The use of ABO compatible donors in theera of lung allocation score was not associated with shorttermor long-term mortality and resulted in equivalentposttransplant lung function. A DLT with carefullyselected ABO compatible donors can result in excellentoutcomes.

Original languageEnglish
Pages (from-to)1167-1174
Number of pages8
JournalAnnals of Thoracic Surgery
Volume98
Issue number4
DOIs
Publication statusPublished - Oct 1 2014

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Tissue Donors
Transplants
Lung
Transplantation
Mortality
Ventilation
Creatinine
Hospitalization
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Examining ABO compatible donors in double lung transplants during the era of lung allocation score. / Taghavi, Sharven; Jayarajan, Senthil N.; Furuya, Yuka; Komaroff, Eugene; Shiose, Akira; Leotta, Eros; Hisamoto, Kazuhiro; Patel, Namrata; Cordova, Francis; Criner, Gerard; Guy, T. Sloane; Toyoda, Yoshiya.

In: Annals of Thoracic Surgery, Vol. 98, No. 4, 01.10.2014, p. 1167-1174.

Research output: Contribution to journalArticle

Taghavi, S, Jayarajan, SN, Furuya, Y, Komaroff, E, Shiose, A, Leotta, E, Hisamoto, K, Patel, N, Cordova, F, Criner, G, Guy, TS & Toyoda, Y 2014, 'Examining ABO compatible donors in double lung transplants during the era of lung allocation score', Annals of Thoracic Surgery, vol. 98, no. 4, pp. 1167-1174. https://doi.org/10.1016/j.athoracsur.2014.05.037
Taghavi, Sharven ; Jayarajan, Senthil N. ; Furuya, Yuka ; Komaroff, Eugene ; Shiose, Akira ; Leotta, Eros ; Hisamoto, Kazuhiro ; Patel, Namrata ; Cordova, Francis ; Criner, Gerard ; Guy, T. Sloane ; Toyoda, Yoshiya. / Examining ABO compatible donors in double lung transplants during the era of lung allocation score. In: Annals of Thoracic Surgery. 2014 ; Vol. 98, No. 4. pp. 1167-1174.
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abstract = "Background. The short-term and long-term effect ofusing ABO compatible donors in the era of lung allocationscore is unknown. This study determined if carefullyselected ABO compatible donors could be used in doublelung transplantation (DLT) with good outcomes.Methods. The United Network for Organ Sharingdatabase was retrospectively reviewed for adult DLTfrom May 2005 to December 2011.Results. Of 6,655 double lung transplants, 493 (7.4{\%})were with ABO compatible donors and 6,162 (92.6{\%}) werewith ABO identical donors. In multivariate analysis, use ofABO compatible donors was not associated with mortalityat 30 days (HR, 1.16; 95{\%} CI, 0.76 to 1.79, p [ 0.49), 1 year(HR, 1.10; 95{\%} CI, 0.86 to 1.42, p [ 0.46), and 5 years (HR,1.06; 95{\%} CI, 0.83 to 1.34, p [ 0.65). Variables associatedwith mortality at 5 years were donor female sex, donor age60 years or greater, prolonged ischemic time, increasingrecipient creatinine, recipient age, race mismatch, andmechanical ventilation or extracorporeal membraneoxygenation as a bridge to transplantation. Length of staywas longer in the ABO compatible group (30.9 vs 25.9 days,p [ 0.001). Acute rejection episodes on index hospitalization(8.8 vs. 8.9{\%}, p [ 1.00), peak posttransplant forcedexpiratory volume in 1 second (FEV1) (82.7 vs 79.7{\%},p [ 0.053), and decrement in FEV1 over time were notdifferent (p[0.13). Freedomfrombronchiolitis obliteranssyndrome was similar (1,475 vs 1,454 days, p[0.17).Conclusions. The use of ABO compatible donors in theera of lung allocation score was not associated with shorttermor long-term mortality and resulted in equivalentposttransplant lung function. A DLT with carefullyselected ABO compatible donors can result in excellentoutcomes.",
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",
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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

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Background. The short-term and long-term effect ofusing ABO compatible donors in the era of lung allocationscore is unknown. This study determined if carefullyselected ABO compatible donors could be used in doublelung transplantation (DLT) with good outcomes.Methods. The United Network for Organ Sharingdatabase was retrospectively reviewed for adult DLTfrom May 2005 to December 2011.Results. Of 6,655 double lung transplants, 493 (7.4%)were with ABO compatible donors and 6,162 (92.6%) werewith ABO identical donors. In multivariate analysis, use ofABO compatible donors was not associated with mortalityat 30 days (HR, 1.16; 95% CI, 0.76 to 1.79, p [ 0.49), 1 year(HR, 1.10; 95% CI, 0.86 to 1.42, p [ 0.46), and 5 years (HR,1.06; 95% CI, 0.83 to 1.34, p [ 0.65). Variables associatedwith mortality at 5 years were donor female sex, donor age60 years or greater, prolonged ischemic time, increasingrecipient creatinine, recipient age, race mismatch, andmechanical ventilation or extracorporeal membraneoxygenation as a bridge to transplantation. Length of staywas longer in the ABO compatible group (30.9 vs 25.9 days,p [ 0.001). Acute rejection episodes on index hospitalization(8.8 vs. 8.9%, p [ 1.00), peak posttransplant forcedexpiratory volume in 1 second (FEV1) (82.7 vs 79.7%,p [ 0.053), and decrement in FEV1 over time were notdifferent (p[0.13). Freedomfrombronchiolitis obliteranssyndrome was similar (1,475 vs 1,454 days, p[0.17).Conclusions. The use of ABO compatible donors in theera of lung allocation score was not associated with shorttermor long-term mortality and resulted in equivalentposttransplant lung function. A DLT with carefullyselected ABO compatible donors can result in excellentoutcomes.

AB - Background. The short-term and long-term effect ofusing ABO compatible donors in the era of lung allocationscore is unknown. This study determined if carefullyselected ABO compatible donors could be used in doublelung transplantation (DLT) with good outcomes.Methods. The United Network for Organ Sharingdatabase was retrospectively reviewed for adult DLTfrom May 2005 to December 2011.Results. Of 6,655 double lung transplants, 493 (7.4%)were with ABO compatible donors and 6,162 (92.6%) werewith ABO identical donors. In multivariate analysis, use ofABO compatible donors was not associated with mortalityat 30 days (HR, 1.16; 95% CI, 0.76 to 1.79, p [ 0.49), 1 year(HR, 1.10; 95% CI, 0.86 to 1.42, p [ 0.46), and 5 years (HR,1.06; 95% CI, 0.83 to 1.34, p [ 0.65). Variables associatedwith mortality at 5 years were donor female sex, donor age60 years or greater, prolonged ischemic time, increasingrecipient creatinine, recipient age, race mismatch, andmechanical ventilation or extracorporeal membraneoxygenation as a bridge to transplantation. Length of staywas longer in the ABO compatible group (30.9 vs 25.9 days,p [ 0.001). Acute rejection episodes on index hospitalization(8.8 vs. 8.9%, p [ 1.00), peak posttransplant forcedexpiratory volume in 1 second (FEV1) (82.7 vs 79.7%,p [ 0.053), and decrement in FEV1 over time were notdifferent (p[0.13). Freedomfrombronchiolitis obliteranssyndrome was similar (1,475 vs 1,454 days, p[0.17).Conclusions. The use of ABO compatible donors in theera of lung allocation score was not associated with shorttermor long-term mortality and resulted in equivalentposttransplant lung function. A DLT with carefullyselected ABO compatible donors can result in excellentoutcomes.

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