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.
authors.affiliation: Departments of Surgery.
authors.forename: Sharven
authors.initials: S
authors.lastname: Taghavi
authors.affiliation: Departments of Surgery.
authors.forename: Senthil N
authors.initials: SN
authors.lastname: Jayarajan
authors.affiliation: Medicine, Temple University School of Medicine.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Furuya
authors.affiliation: Department of Public Health, Temple University.
authors.forename: Eugene
authors.initials: E
authors.lastname: Komaroff
authors.affiliation: Section of Cardiothoracic Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Akira
authors.initials: A
authors.lastname: Shiose
authors.affiliation: Section of Cardiothoracic Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Eros
authors.initials: E
authors.lastname: Leotta
authors.affiliation: Section of Cardiothoracic Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hisamoto
authors.affiliation: Medicine, Temple University School of Medicine.
authors.forename: Namrata
authors.initials: N
authors.lastname: Patel
authors.affiliation: Medicine, Temple University School of Medicine.
authors.forename: Francis
authors.initials: F
authors.lastname: Cordova
authors.affiliation: Medicine, Temple University School of Medicine.
authors.forename: Gerard
authors.initials: G
authors.lastname: Criner
authors.affiliation: Section of Cardiothoracic Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: T Sloane
authors.initials: TS
authors.lastname: Guy
authors.affiliation: Section of Cardiothoracic Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania. Electronic address: yoshiya.toyoda@tuhs.temple.edu.
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Toyoda
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006648:Histocompatibility / Q000276:immunology; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008171:Lung Diseases / Q000097:blood* / Q000401:mortality / Q000601:surgery*; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D016896:Treatment Outcome
chemical_list: D000017:ABO Blood-Group System
keywords: ABO-compatible donors; ABO-identical donors; outcomes; single-lung transplantation