Back to Search
Start Over
Effect of ABO-incompatible listing on infant heart transplant waitlist outcomes: analysis of the United Network for Organ Sharing (UNOS) database.
- Source :
-
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation [J Heart Lung Transplant] 2009 Dec; Vol. 28 (12), pp. 1254-60. Date of Electronic Publication: 2009 Sep 26. - Publication Year :
- 2009
-
Abstract
- Background: Midterm heart transplant outcomes of ABO-incompatible (ABO-I) organ use in infants are favorable. ABO-I transplantation has resulted in reduced waitlist mortality in some countries. This study assessed the effect of an ABO-I listing strategy on pre-transplant outcomes in the United States.<br />Methods: The Organ Procurement and Transplantation Network (OPTN)/United Network of Organ Sharing (UNOS) database was used to identify infants aged younger than 1 year listed as status 1 for heart transplantation between January 1, 2001, and May 20, 2008. The cohort was divided into 2 groups: eligible for ABO-compatible (ABO-C) transplant and eligible for ABO-I transplant. Baseline characteristics, waitlist times, and outcomes were compared in univariate analysis. Competing risks analysis evaluated differences in time to transplant in the presence of other outcomes.<br />Results: Of 1,029 infants listed for transplant, 277 (27%) were listed for an ABO-I transplant. Overall, 92% of transplant recipients received an ABO-C organ regardless of listing type. Among recipients eligible for ABO-I, only 27% received an ABO-I organ. The percentage that underwent transplant in each group did not differ. Although infants listed for an ABO-I organ had a shorter wait time for transplant, waitlist mortality was similar.<br />Conclusions: Despite the intended merits of ABO-I heart transplantation, ABO-I listing and organ acceptance have not yielded lower waitlist mortality in the United States under the current UNOS allocation algorithm. Consideration should be given to altering the allocation system to one that gives less preference toward blood group compatibility in hopes of improving organ use and reducing waitlist mortality.
- Subjects :
- Heart Diseases mortality
Humans
Infant
Infant, Newborn
Retrospective Studies
Survival Rate trends
Time Factors
Tissue Donors statistics & numerical data
United States epidemiology
ABO Blood-Group System
Blood Group Incompatibility epidemiology
Databases, Factual
Heart Diseases surgery
Heart Transplantation statistics & numerical data
Waiting Lists
Subjects
Details
- Language :
- English
- ISSN :
- 1557-3117
- Volume :
- 28
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 19782582
- Full Text :
- https://doi.org/10.1016/j.healun.2009.06.024