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

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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 languageEnglish
Pages (from-to)822-828
Number of pages7
JournalJournal of Heart and Lung Transplantation
Volume33
Issue number8
DOIs
Publication statusPublished - Aug 2014
Externally publishedYes

All Science Journal Classification (ASJC) codes

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

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    Taghavi, S., Jayarajan, S. N., Furuya, Y., Komaroff, E., Shiose, A., Leotta, E., Hisamoto, K., Patel, N., Cordova, F., Criner, G., Guy, T. S., & Toyoda, Y. (2014). Single-lung transplantation with ABO-compatible donors results in excellent outcomes. Journal of Heart and Lung Transplantation, 33(8), 822-828. https://doi.org/10.1016/j.healun.2014.04.006