Back to Search
Start Over
Association between recipient blood type and heart transplantation outcomes in the United States
- Source :
- The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation. 39(4)
- Publication Year :
- 2019
-
Abstract
- In heart transplantation (HT), although blood type O organs can go to any blood type, non-O organs may not be allocated to adult O recipients. Therefore, O candidates wait longer than non-O candidates and frequently require bridging with left ventricular assist devices (LVADs). The effects of this discrepancy are rarely investigated in a large registry. The purpose of this study was to assess the association between candidates' blood type and their outcomes after HT listing.This is a retrospective cohort study using the United Network for Organ Sharing Registry, including 34,352 candidates listed for a single-organ, primary HT from January 2000 through December 2015. Main outcome measures were waitlist mortality and post-HT mortality, using blood type A as reference. We conducted inverse-probability weighting to adjust for baseline profiles.Among 34,352 candidates (median age 55, interquartile range 46-62; female 24.8%; blood type A: 13,258, AB: 1,572, B: 4,599, O:14,923), 22,714 candidates (A: 71.5%, AB: 82.1%, B: 73.0%, O: 57.5%; p0.001) underwent HT during the study period. Among recipients, bridging LVAD rate was highest in O recipients (A: 23.0%, AB: 15.3%, B: 23.4%, O: 32.1%; p0.001). After inverse-probability weighting, O patients demonstrated a significantly higher hazard of death after listing (adjusted hazard ratio 1.11, 95% confidence interval [CI] 1.07-1.16) and after HT (adjusted hazard ratio 1.07, 95% CI 1.01-1.13) as compared with A.There is a survival discrepancy among blood types. Our findings should facilitate more prospective studies to revisit current policies regarding equity in allocation, where possible.
- Subjects :
- Pulmonary and Respiratory Medicine
United Network for Organ Sharing
Male
medicine.medical_specialty
Waiting Lists
medicine.medical_treatment
030204 cardiovascular system & hematology
030230 surgery
03 medical and health sciences
0302 clinical medicine
Interquartile range
Internal medicine
medicine
Humans
Registries
Prospective cohort study
Retrospective Studies
Heart transplantation
Blood type
Heart Failure
Transplantation
business.industry
Outcome measures
Retrospective cohort study
Middle Aged
United States
Survival Rate
Blood Group Antigens
Heart Transplantation
Surgery
Female
Waitlist mortality
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 15573117
- Volume :
- 39
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
- Accession number :
- edsair.doi.dedup.....a8331d71ebe2df2a463069b3e30a29a9