Donor–recipient matching in lung transplantation: which variables are important?
OBJECTIVES Donor to recipient (D/R) matching in lung transplantation (LTx) is usually directed by blood group (identity or compatibility) and predicted total lung capacity (pTLC) based on height and age. Other donor (D) and recipient (R) characteristics such as cytomegalovirus (CMV) serology (±), ge...
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| Veröffentlicht in: | European journal of cardio-thoracic surgery 2015-06, Vol.47 (6), p.974-983 |
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| container_title | European journal of cardio-thoracic surgery |
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| creator | Demir, Adalet Coosemans, Willy Decaluwé, Herbert De Leyn, Paul Nafteux, Philippe Van Veer, Hans Verleden, Geert M. Van Raemdonck, Dirk |
| description | OBJECTIVES
Donor to recipient (D/R) matching in lung transplantation (LTx) is usually directed by blood group (identity or compatibility) and predicted total lung capacity (pTLC) based on height and age. Other donor (D) and recipient (R) characteristics such as cytomegalovirus (CMV) serology (±), gender [male (M)/ female (F)] and age are often ignored, but the impact of D/R mismatch for these variables and their combinations on outcome is less investigated.
METHODS
The early and late outcomes in 461 lung recipients (149 single-lung and 312 double-lung) transplanted between July 1991 and December 2009 were explored, comparing different D/R combinations for gender (M/F), age ( |
| doi_str_mv | 10.1093/ejcts/ezu340 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1682425159</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ejcts/ezu340</oup_id><sourcerecordid>1682425159</sourcerecordid><originalsourceid>FETCH-LOGICAL-c291t-30eff256713fcd05af998099567bf052a92a0f476159b356429eea4e923efa143</originalsourceid><addsrcrecordid>eNp9kMtKxDAUhoMozji6cy3d6cI6uTTtxI3IeIUBQRTclbRz4mRom5qkiq58B9_QJzHa0aWr_3D4-DnnQ2iX4COCBRvDsvRuDG8dS_AaGpJJxuKMJQ_rYcYEx5lI8ABtObfEGKeMZptoQHnAOKNDdHtmGmM_3z8slLrV0Piolr5c6OYx0k1UdSG9lY1rK9l46bVpjqOXhS4X0bO0WhYVuEhaiHTdGusDc7KNNpSsHOyscoTuL87vplfx7Obyeno6i0sqiI8ZBqUoTzPCVDnHXCohJliIsCkU5lQKKrFKspRwUTCeJlQAyAQEZaAkSdgIHfS9rTVPHTif19qVUIVDwXQuJ-mEJuFTLgJ62KOlNc5ZUHlrdS3ta05w_m0x_7GY9xYDvrdq7ooa5n_wr7YA7PeA6dr_q74Absx-Xg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1682425159</pqid></control><display><type>article</type><title>Donor–recipient matching in lung transplantation: which variables are important?</title><source>MEDLINE</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Demir, Adalet ; Coosemans, Willy ; Decaluwé, Herbert ; De Leyn, Paul ; Nafteux, Philippe ; Van Veer, Hans ; Verleden, Geert M. ; Van Raemdonck, Dirk</creator><creatorcontrib>Demir, Adalet ; Coosemans, Willy ; Decaluwé, Herbert ; De Leyn, Paul ; Nafteux, Philippe ; Van Veer, Hans ; Verleden, Geert M. ; Van Raemdonck, Dirk</creatorcontrib><description>OBJECTIVES
Donor to recipient (D/R) matching in lung transplantation (LTx) is usually directed by blood group (identity or compatibility) and predicted total lung capacity (pTLC) based on height and age. Other donor (D) and recipient (R) characteristics such as cytomegalovirus (CMV) serology (±), gender [male (M)/ female (F)] and age are often ignored, but the impact of D/R mismatch for these variables and their combinations on outcome is less investigated.
METHODS
The early and late outcomes in 461 lung recipients (149 single-lung and 312 double-lung) transplanted between July 1991 and December 2009 were explored, comparing different D/R combinations for gender (M/F), age (<20/21 to 45/≥45 years), CMV (±), blood group (identical/compatible) and pTLC (−9%Δ, +11%Δ).
RESULTS
Overall 5-, 10-, 15- and 20-year survival rates were 69, 50, 37 and 37%, respectively, and were significantly better in females {HR [95% confidence interval (CI)]: 0.5 (0.3–0.9); P = 0.023} and worse in older recipients [HR (95% CI): 1.6 (1.2–2.2); P = 0.003]. On univariate analysis, survival was significantly worse in recipients with gender opposite to that of the donor (39% for mismatch vs 51% for match at 10 years; P = 0.04), but not for other D/R matching variables: age (P = 0.89), pTLC (P = 0.14), CMV (P = 0.15), blood group (P = 0.82) and their combinations. The best survival at 5 years was seen in female donor (DF)/female recipient (RF) (80%), the worst in DF/male recipient (RM) (47%), and intermediate in male donor (DM)/RF (72%) and DM/RM (63%); P = 0.0001. On multivariate analysis, D/R gender mismatch was found to be the sole negative predictive factor for survival with an 80% increased risk of mortality [HR (95% CI): 1.8 (1.1–2.8); P = 0.01].
CONCLUSIONS
In our patient cohort, survival after LTx was superior in female and younger recipients. D/R gender mismatch may be an important prognostic factor for long-term outcome. A gender combination of DF/RM should be avoided. The exact reasons for these differences remain speculative.</description><identifier>ISSN: 1010-7940</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1093/ejcts/ezu340</identifier><identifier>PMID: 25187532</identifier><language>eng</language><publisher>Germany: Oxford University Press</publisher><subject>ABO Blood-Group System ; Adult ; Female ; Humans ; Kaplan-Meier Estimate ; Lung Transplantation - statistics & numerical data ; Male ; Middle Aged ; Retrospective Studies ; Tissue Donors - statistics & numerical data ; Transplant Recipients - statistics & numerical data</subject><ispartof>European journal of cardio-thoracic surgery, 2015-06, Vol.47 (6), p.974-983</ispartof><rights>The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. 2014</rights><rights>The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c291t-30eff256713fcd05af998099567bf052a92a0f476159b356429eea4e923efa143</citedby><cites>FETCH-LOGICAL-c291t-30eff256713fcd05af998099567bf052a92a0f476159b356429eea4e923efa143</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1583,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25187532$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Demir, Adalet</creatorcontrib><creatorcontrib>Coosemans, Willy</creatorcontrib><creatorcontrib>Decaluwé, Herbert</creatorcontrib><creatorcontrib>De Leyn, Paul</creatorcontrib><creatorcontrib>Nafteux, Philippe</creatorcontrib><creatorcontrib>Van Veer, Hans</creatorcontrib><creatorcontrib>Verleden, Geert M.</creatorcontrib><creatorcontrib>Van Raemdonck, Dirk</creatorcontrib><title>Donor–recipient matching in lung transplantation: which variables are important?</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><description>OBJECTIVES
Donor to recipient (D/R) matching in lung transplantation (LTx) is usually directed by blood group (identity or compatibility) and predicted total lung capacity (pTLC) based on height and age. Other donor (D) and recipient (R) characteristics such as cytomegalovirus (CMV) serology (±), gender [male (M)/ female (F)] and age are often ignored, but the impact of D/R mismatch for these variables and their combinations on outcome is less investigated.
METHODS
The early and late outcomes in 461 lung recipients (149 single-lung and 312 double-lung) transplanted between July 1991 and December 2009 were explored, comparing different D/R combinations for gender (M/F), age (<20/21 to 45/≥45 years), CMV (±), blood group (identical/compatible) and pTLC (−9%Δ, +11%Δ).
RESULTS
Overall 5-, 10-, 15- and 20-year survival rates were 69, 50, 37 and 37%, respectively, and were significantly better in females {HR [95% confidence interval (CI)]: 0.5 (0.3–0.9); P = 0.023} and worse in older recipients [HR (95% CI): 1.6 (1.2–2.2); P = 0.003]. On univariate analysis, survival was significantly worse in recipients with gender opposite to that of the donor (39% for mismatch vs 51% for match at 10 years; P = 0.04), but not for other D/R matching variables: age (P = 0.89), pTLC (P = 0.14), CMV (P = 0.15), blood group (P = 0.82) and their combinations. The best survival at 5 years was seen in female donor (DF)/female recipient (RF) (80%), the worst in DF/male recipient (RM) (47%), and intermediate in male donor (DM)/RF (72%) and DM/RM (63%); P = 0.0001. On multivariate analysis, D/R gender mismatch was found to be the sole negative predictive factor for survival with an 80% increased risk of mortality [HR (95% CI): 1.8 (1.1–2.8); P = 0.01].
CONCLUSIONS
In our patient cohort, survival after LTx was superior in female and younger recipients. D/R gender mismatch may be an important prognostic factor for long-term outcome. A gender combination of DF/RM should be avoided. The exact reasons for these differences remain speculative.</description><subject>ABO Blood-Group System</subject><subject>Adult</subject><subject>Female</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Lung Transplantation - statistics & numerical data</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Tissue Donors - statistics & numerical data</subject><subject>Transplant Recipients - statistics & numerical data</subject><issn>1010-7940</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtKxDAUhoMozji6cy3d6cI6uTTtxI3IeIUBQRTclbRz4mRom5qkiq58B9_QJzHa0aWr_3D4-DnnQ2iX4COCBRvDsvRuDG8dS_AaGpJJxuKMJQ_rYcYEx5lI8ABtObfEGKeMZptoQHnAOKNDdHtmGmM_3z8slLrV0Piolr5c6OYx0k1UdSG9lY1rK9l46bVpjqOXhS4X0bO0WhYVuEhaiHTdGusDc7KNNpSsHOyscoTuL87vplfx7Obyeno6i0sqiI8ZBqUoTzPCVDnHXCohJliIsCkU5lQKKrFKspRwUTCeJlQAyAQEZaAkSdgIHfS9rTVPHTif19qVUIVDwXQuJ-mEJuFTLgJ62KOlNc5ZUHlrdS3ta05w_m0x_7GY9xYDvrdq7ooa5n_wr7YA7PeA6dr_q74Absx-Xg</recordid><startdate>201506</startdate><enddate>201506</enddate><creator>Demir, Adalet</creator><creator>Coosemans, Willy</creator><creator>Decaluwé, Herbert</creator><creator>De Leyn, Paul</creator><creator>Nafteux, Philippe</creator><creator>Van Veer, Hans</creator><creator>Verleden, Geert M.</creator><creator>Van Raemdonck, Dirk</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201506</creationdate><title>Donor–recipient matching in lung transplantation: which variables are important?</title><author>Demir, Adalet ; Coosemans, Willy ; Decaluwé, Herbert ; De Leyn, Paul ; Nafteux, Philippe ; Van Veer, Hans ; Verleden, Geert M. ; Van Raemdonck, Dirk</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c291t-30eff256713fcd05af998099567bf052a92a0f476159b356429eea4e923efa143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>ABO Blood-Group System</topic><topic>Adult</topic><topic>Female</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Lung Transplantation - statistics & numerical data</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Tissue Donors - statistics & numerical data</topic><topic>Transplant Recipients - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Demir, Adalet</creatorcontrib><creatorcontrib>Coosemans, Willy</creatorcontrib><creatorcontrib>Decaluwé, Herbert</creatorcontrib><creatorcontrib>De Leyn, Paul</creatorcontrib><creatorcontrib>Nafteux, Philippe</creatorcontrib><creatorcontrib>Van Veer, Hans</creatorcontrib><creatorcontrib>Verleden, Geert M.</creatorcontrib><creatorcontrib>Van Raemdonck, Dirk</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Demir, Adalet</au><au>Coosemans, Willy</au><au>Decaluwé, Herbert</au><au>De Leyn, Paul</au><au>Nafteux, Philippe</au><au>Van Veer, Hans</au><au>Verleden, Geert M.</au><au>Van Raemdonck, Dirk</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Donor–recipient matching in lung transplantation: which variables are important?</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>2015-06</date><risdate>2015</risdate><volume>47</volume><issue>6</issue><spage>974</spage><epage>983</epage><pages>974-983</pages><issn>1010-7940</issn><eissn>1873-734X</eissn><abstract>OBJECTIVES
Donor to recipient (D/R) matching in lung transplantation (LTx) is usually directed by blood group (identity or compatibility) and predicted total lung capacity (pTLC) based on height and age. Other donor (D) and recipient (R) characteristics such as cytomegalovirus (CMV) serology (±), gender [male (M)/ female (F)] and age are often ignored, but the impact of D/R mismatch for these variables and their combinations on outcome is less investigated.
METHODS
The early and late outcomes in 461 lung recipients (149 single-lung and 312 double-lung) transplanted between July 1991 and December 2009 were explored, comparing different D/R combinations for gender (M/F), age (<20/21 to 45/≥45 years), CMV (±), blood group (identical/compatible) and pTLC (−9%Δ, +11%Δ).
RESULTS
Overall 5-, 10-, 15- and 20-year survival rates were 69, 50, 37 and 37%, respectively, and were significantly better in females {HR [95% confidence interval (CI)]: 0.5 (0.3–0.9); P = 0.023} and worse in older recipients [HR (95% CI): 1.6 (1.2–2.2); P = 0.003]. On univariate analysis, survival was significantly worse in recipients with gender opposite to that of the donor (39% for mismatch vs 51% for match at 10 years; P = 0.04), but not for other D/R matching variables: age (P = 0.89), pTLC (P = 0.14), CMV (P = 0.15), blood group (P = 0.82) and their combinations. The best survival at 5 years was seen in female donor (DF)/female recipient (RF) (80%), the worst in DF/male recipient (RM) (47%), and intermediate in male donor (DM)/RF (72%) and DM/RM (63%); P = 0.0001. On multivariate analysis, D/R gender mismatch was found to be the sole negative predictive factor for survival with an 80% increased risk of mortality [HR (95% CI): 1.8 (1.1–2.8); P = 0.01].
CONCLUSIONS
In our patient cohort, survival after LTx was superior in female and younger recipients. D/R gender mismatch may be an important prognostic factor for long-term outcome. A gender combination of DF/RM should be avoided. The exact reasons for these differences remain speculative.</abstract><cop>Germany</cop><pub>Oxford University Press</pub><pmid>25187532</pmid><doi>10.1093/ejcts/ezu340</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | European journal of cardio-thoracic surgery, 2015-06, Vol.47 (6), p.974-983 |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | ABO Blood-Group System Adult Female Humans Kaplan-Meier Estimate Lung Transplantation - statistics & numerical data Male Middle Aged Retrospective Studies Tissue Donors - statistics & numerical data Transplant Recipients - statistics & numerical data |
| title | Donor–recipient matching in lung transplantation: which variables are important? |
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