Cardiac transplantation with ABO-compatible donors has equivalent long-term survival

Abstract

Background: We sought to determine the long-term effects of ABO-compatible donors (ACD) in adult cardiac transplantation (OHT).

Methods: The United Network for Organ Sharing database was examined for adult OHT from 2000 to 2010.

Results: Of 20,353 patients undergoing OHT, 3,046 (15%) were with ACD. Recipients of ACD were younger (51.2 vs 52.0 years; P = .002), less likely male (74.1 vs 76.5; P = .004), and had shorter ischemic time (3.1 vs 3.2 hours; P < .001). The 2 groups had similar donor age (31.5 vs 31.5; P = .973), preponderance of male gender (70.9% vs 71.4%; P = .341), and gender mismatching (27.8 vs 27.9; P = .956). Recipients of ACD had similar duration of stay (20.4 vs 20.1 days; P = .544) and median survival times were similar (3,961 vs 4,005 days; P = .078). On multivariate analysis, ACD were associated with increased mortality at 1 year (hazard ratio [HR], 1.139; 95% confidence interval [CI], 1.015-1.278; P = .027). ACD were not associated with mortality at 10 years (HR, 1.032; 95% CI, 0.952-1.119; P = .437). Variables associated with mortality at 10 years included donor age, ischemic time, recipient creatinine, recipient black race, congenital disease, restrictive cardiomyopathy, status 1A, gender mismatch, race mismatch, and mechanical ventilation or extracorporeal membrane oxygenation as a bridge to transplantation.

Conclusion: OHT with select ACD results in equivalent long-term survival.