Does Lung Donation by Heart Donors Have an Impact on Survival in Heart Transplant Recipients?

Y. Xia, Patricia Friedmann, R. Bello, Daniel J. Goldstein, D. D'Alessandro

Research output: Contribution to journalArticle

Abstract

Lung procurement is increasing during multiorgan recovery and substantially alters the explant process. This study evaluated whether lung donation by a heart donor affects survival in heart transplant recipients. Retrospective analysis of United Network for Organ Sharing (UNOS) adult heart transplantation data from 1998 to 2012 was performed. Lung donors (LDs) were defined as those having at least one lung procured and transplanted. Non-LDs had neither lung transplanted. Heart transplant recipients who had previous transplants, who had heterotopic transplants, who were waitlisted for other organs or who were temporarily delisted were excluded from the analysis. Kaplan-Meier survival analysis and Cox proportional hazards regression were performed. Of 23 590 heart transplant recipients meeting criteria during the study period, 8638 (36.6%) transplants were from LDs. Donors in the LD group had less history of cigarette use (15.5% vs. 29.5%, p < 0.001). On univariate analysis, LDs were associated with improved patient survival (p < 0.001). On multivariate analysis, LDs were not significantly associated with patient survival (adjusted hazard ratio 0.98, 95% confidence interval 0.94-1.03). Analysis of the UNOS registry suggested that donor pulmonary status and lung procurement had no detrimental effect on survival in heart transplant recipients, supporting the present practice of using donor lungs whenever possible.

Original languageEnglish (US)
JournalAmerican Journal of Transplantation
DOIs
StateAccepted/In press - 2016

Fingerprint

Tissue Donors
Lung
Survival
Transplants
Transplant Recipients
Kaplan-Meier Estimate
Heart Transplantation
Survival Analysis
Tobacco Products
Registries
Multivariate Analysis
Confidence Intervals

Keywords

  • Clinical research/practice
  • Donors and donation
  • Health services and outcomes research
  • Heart transplantation/cardiology
  • Organ procurement
  • Organ procurement and allocation
  • Patient survival
  • Registry/registry analysis
  • United Network for Organ Sharing (UNOS)

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Cite this

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title = "Does Lung Donation by Heart Donors Have an Impact on Survival in Heart Transplant Recipients?",
abstract = "Lung procurement is increasing during multiorgan recovery and substantially alters the explant process. This study evaluated whether lung donation by a heart donor affects survival in heart transplant recipients. Retrospective analysis of United Network for Organ Sharing (UNOS) adult heart transplantation data from 1998 to 2012 was performed. Lung donors (LDs) were defined as those having at least one lung procured and transplanted. Non-LDs had neither lung transplanted. Heart transplant recipients who had previous transplants, who had heterotopic transplants, who were waitlisted for other organs or who were temporarily delisted were excluded from the analysis. Kaplan-Meier survival analysis and Cox proportional hazards regression were performed. Of 23 590 heart transplant recipients meeting criteria during the study period, 8638 (36.6{\%}) transplants were from LDs. Donors in the LD group had less history of cigarette use (15.5{\%} vs. 29.5{\%}, p < 0.001). On univariate analysis, LDs were associated with improved patient survival (p < 0.001). On multivariate analysis, LDs were not significantly associated with patient survival (adjusted hazard ratio 0.98, 95{\%} confidence interval 0.94-1.03). Analysis of the UNOS registry suggested that donor pulmonary status and lung procurement had no detrimental effect on survival in heart transplant recipients, supporting the present practice of using donor lungs whenever possible.",
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AU - Xia, Y.

AU - Friedmann, Patricia

AU - Bello, R.

AU - Goldstein, Daniel J.

AU - D'Alessandro, D.

PY - 2016

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