title: Examining ABO compatible donors in double lung transplants during the era of lung allocation score.
abstract: BACKGROUND
  The short-term and long-term effect of using ABO compatible donors in the era of lung allocation score is unknown. This study determined if carefully selected ABO compatible donors could be used in double lung transplantation (DLT) with good outcomes.
  
  
  METHODS
  The United Network for Organ Sharing database was retrospectively reviewed for adult DLT from 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%) were with ABO identical donors. In multivariate analysis, use of ABO compatible donors was not associated with mortality at 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 associated with mortality at 5 years were donor female sex, donor age 60 years or greater, prolonged ischemic time, increasing recipient creatinine, recipient age, race mismatch, and mechanical ventilation or extracorporeal membrane oxygenation as a bridge to transplantation. Length of stay was 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 forced expiratory volume in 1 second (FEV1) (82.7 vs 79.7%, p = 0.053), and decrement in FEV1 over time were not different (p = 0.13). Freedom from bronchiolitis obliterans syndrome was similar (1,475 vs 1,454 days, p = 0.17).
  
  
  CONCLUSIONS
  The use of ABO compatible donors in the era of lung allocation score was not associated with short-term or long-term mortality and resulted in equivalent posttransplant lung function. A DLT with carefully selected ABO compatible donors can result in excellent outcomes.
authors.affiliation: Department of Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Sharven
authors.initials: S
authors.lastname: Taghavi
authors.affiliation: Department of Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Senthil N
authors.initials: SN
authors.lastname: Jayarajan
authors.affiliation: Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Furuya
authors.affiliation: Department of Public Health, Temple University, Philadelphia, Pennsylvania.
authors.forename: Eugene
authors.initials: E
authors.lastname: Komaroff
authors.affiliation: Section of Cardiothoracic Surgery, Temple University, Philadelphia, Pennsylvania.
authors.forename: Akira
authors.initials: A
authors.lastname: Shiose
authors.affiliation: Section of Cardiothoracic Surgery, Temple University, Philadelphia, Pennsylvania.
authors.forename: Eros
authors.initials: E
authors.lastname: Leotta
authors.affiliation: Section of Cardiothoracic Surgery, Temple University, Philadelphia, Pennsylvania.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hisamoto
authors.affiliation: Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Namrata
authors.initials: N
authors.lastname: Patel
authors.affiliation: Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Francis
authors.initials: F
authors.lastname: Cordova
authors.affiliation: Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Gerard
authors.initials: G
authors.lastname: Criner
authors.affiliation: Section of Cardiothoracic Surgery, Temple University, Philadelphia, Pennsylvania.
authors.forename: T Sloane
authors.initials: TS
authors.lastname: Guy
authors.affiliation: Section of Cardiothoracic Surgery, Temple University, 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; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement
chemical_list: D000017:ABO Blood-Group System