title: Transfusion with packed red blood cells while awaiting lung transplantation is associated with reduced survival after lung transplantation.
abstract: The effect of pretransplant transfusion of red blood cells on survival after lung transplantation (LTx) has not been studied.
  
  
  
  The UNOS database was queried from 2005 to 2013 to compare survival in recipients receiving a transfusion while on the LTx wait list.
  
  
  
  Of 12 283 adult patients undergoing single or bilateral LTx from May 2005 onwards, 11 801 met inclusion criteria, among whom 512 required transfusion while on the LTx wait list. Transfusion was associated with a higher mortality hazard in unadjusted Cox proportional hazards analysis (HR=1.296; 95% CI: 1.124, 1.494; P<.001), and in a multivariable Cox model (HR=1.178; 95% CI: 1.013, 1.369; P=.033) after multiple imputation was used to complete data on covariates. Propensity score matching was used to match transfusion recipients to nonrecipients on the likelihood of having received transfusions on the wait list, calculated from characteristics at the time of listing. Unadjusted Cox regression stratified on the matched pairs also demonstrated an association between transfusion receipt on the wait list and higher post-transplant mortality hazard (HR=1.494; 95% CI: 1.127, 1.979; P=.005).
  
  
  
  Blood transfusion while on the LTx wait list was associated with diminished patient survival after transplantation.
authors.affiliation: Department of Pediatrics, The Ohio State University, Columbus, OH, USA.|Department of Internal Medicine, The Ohio State University, Columbus, OH, USA.|Department of Surgery, The Ohio State University, Columbus, OH, USA.|Center for Epidemiology of Organ Failure and Transplantation, Nationwide Children's Hospital, Columbus, OH, USA.|Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Don
authors.initials: D
authors.lastname: Hayes
authors.affiliation: Department of Pediatrics, The Ohio State University, Columbus, OH, USA.|Center for Epidemiology of Organ Failure and Transplantation, Nationwide Children's Hospital, Columbus, OH, USA.|Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Dmitry
authors.initials: D
authors.lastname: Tumin
authors.affiliation: Department of Pediatrics, The Ohio State University, Columbus, OH, USA.|Section of Cardiology, Nationwide Children's Hospital, Columbus, OH, USA.|Section of Critical Care, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Yates
authors.affiliation: Colleges of Pharmacy and Medicine, The University of Arizona, Tucson, AZ, USA.
authors.forename: Heidi M
authors.initials: HM
authors.lastname: Mansour
authors.affiliation: Center for Epidemiology of Organ Failure and Transplantation, Nationwide Children's Hospital, Columbus, OH, USA.|Department of Pathology, The Ohio State University, Columbus, OH, USA.
authors.forename: Kathleen K
authors.initials: KK
authors.lastname: Nicol
authors.affiliation: Center for Epidemiology of Organ Failure and Transplantation, Nationwide Children's Hospital, Columbus, OH, USA.|Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.|Section of Critical Care, Nationwide Children's Hospital, Columbus, OH, USA.|Department of Anesthesiology, The Ohio State University, Columbus, OH, USA.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tobias
authors.affiliation: William G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, OH, USA.
authors.forename: Andre F
authors.initials: AF
authors.lastname: Palmer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016040:Lung Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D057216:Propensity Score; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D014850:Waiting Lists; D055815:Young Adult
keywords: adult; lung transplantation; survival; transfusion