The use of extended criteria donors decreases one-year survival in high-risk lung recipients: A review of the United Network of Organ Sharing Database

Abstract Objective The study objective was to investigate the impact of matching donor quality to recipient severity on survival after lung transplant. Methods By using the Organ Procurement and Transplantation Network/United Network for Organ Sharing dataset, we analyzed lung transplant recipients...

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Published in:The Journal of thoracic and cardiovascular surgery 2016-09, Vol.152 (3), p.891-898.e2
Main Authors: Mulligan, Matthew J., BA, Sanchez, Pablo G., MD, PhD, Evans, Charles F., MD, Wang, Yan, BM, DrPH, Kon, Zachary N., MD, Rajagopal, Keshava, MD, PhD, Iacono, Aldo T., MD, Gammie, James S., MD, Griffith, Bartley P., MD, Pham, Si M., MD
Format: Article
Language:English
Subjects:
Cardiothoracic Surgery
extended lung donor
lung transplantation
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Summary:Abstract Objective The study objective was to investigate the impact of matching donor quality to recipient severity on survival after lung transplant. Methods By using the Organ Procurement and Transplantation Network/United Network for Organ Sharing dataset, we analyzed lung transplant recipients from May 4, 2005, to December 31, 2012. By using adjusted Cox regressions, we identified extended criteria donors as those who had 1 or more of the following: age 65 years or more, smoking history of 20 pack-years or more, diabetes mellitus, or African-American race. All other donors were considered standard donors. Recipients were categorized by lung allocation score: lung allocation score less than 70 and lung allocation score 70 or greater. Our primary outcome was 1-year survival after lung transplantation. Results Of the 10,995 lung recipients, 3792 (34%) received extended criteria donor organs. Extended criteria donors were associated with an increased hazard of death (hazard ratio [HR], 1.41; 95% confidence interval [CI], 1.26-1.56; P  
ISSN:0022-5223
1097-685X
DOI:10.1016/j.jtcvs.2016.03.096