Document Detail


Impact of ABO-incompatible listing on wait-list outcomes among infants listed for heart transplantation in the United States: a propensity analysis.
MedLine Citation:
PMID:  20404257     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purported advantage of ABO-incompatible (ABO-I) listing is to reduce wait times and wait-list mortality among infants awaiting heart transplantation. We sought to describe recent trends in ABO-I listing for US infants and to determine the impact of ABO-I listing on wait times and wait-list mortality. METHODS AND RESULTS: In this multicenter retrospective cohort study using Organ Procurement and Transplant Network data, infants<12 months of age listed for heart transplantation between 1999 and 2008 (n=1331) were analyzed. Infants listed for an ABO-I transplant were compared with a propensity score-matched cohort listed for an ABO-compatible transplant through the use of a Cox shared-frailty model. The primary end point was time to heart transplantation. The percentage of eligible infants listed for an ABO-I heart increased from 0% before 2002 to 53% in 2007 (P<0.001 for trend). Compared with infants listed exclusively for an ABO-compatible heart, infants with a primary ABO-I listing strategy (n=235) were more likely to be listed 1A, to have congenital heart disease and renal failure, and to require extracorporeal membrane oxygenation. For the propensity score-matched groups (n=197 matched pairs), there was no difference in wait-list mortality; however, infants with blood type O assigned an ABO-I listing strategy were more likely to undergo heart transplantation by 30 days (31% versus 16%; P=0.007) with a less pronounced effect for infants with other blood types. CONCLUSIONS: The proportion of US infants listed for an ABO-I heart transplantation has risen dramatically in recent years but still appears to be preferentially used for sicker infant candidates. The ABO-I listing strategy is associated with a higher likelihood of transplantation within 30 days for infants with blood group O and may benefit a broader range of transplantation candidates.
Authors:
Christopher S Almond; Kimberlee Gauvreau; Ravi R Thiagarajan; Gary E Piercey; Elizabeth D Blume; Leslie B Smoot; Francis Fynn-Thompson; Tajinder P Singh
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural     Date:  2010-04-19
Journal Detail:
Title:  Circulation     Volume:  121     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-04     Completed Date:  2010-05-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1926-33     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Children's Hospital Boston, and Department of Pediatrics, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, USA. christopher.almond@cardio.chboston.org
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MeSH Terms
Descriptor/Qualifier:
ABO Blood-Group System / immunology*
Child
Child, Preschool
Female
Follow-Up Studies
Heart Failure* / immunology,  mortality,  surgery
Heart Transplantation / immunology*,  mortality*
Histocompatibility / immunology*
Humans
Infant
Infant, Newborn
Male
Proportional Hazards Models
Retrospective Studies
Tissue Donors / supply & distribution
Tissue and Organ Procurement / statistics & numerical data
United States / epidemiology
Waiting Lists*
Grant Support
ID/Acronym/Agency:
T32 HL00757-24/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/ABO Blood-Group System
Comments/Corrections
Comment In:
Circulation. 2010 May 4;121(17):1884-6   [PMID:  20404260 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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