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Greissman S, Anderson M, Dimango A, Grewal H, Magda G, Robbins H, Shah L, Costa J, Stanifer B, D'-Ovidio F, Juarez ML, Lemaitre P, Sonett J, Arcasoy S, Benvenuto L. Lung transplant waitlist outcomes among ABO blood groups vary based on disease severity. J Heart Lung Transplant 2023; 42:480-487. [PMID: 36464610 PMCID: PMC10123800 DOI: 10.1016/j.healun.2022.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 10/06/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Blood group O candidates have lower lung transplantation rates despite having the most common blood group. We postulated that waitlist outcomes among these candidates and those with other blood types vary with disease severity and lung allocation score (LAS). METHODS We performed a retrospective cohort study of 32,772 waitlist candidates using the United Network of Organ Sharing registry from May 2005 to 2020. After identifying an interaction between blood group and LAS, we evaluated the association between blood group and waitlist outcomes within LAS quartiles using unadjusted and adjusted competing risk models. RESULTS In the lowest LAS quartile, blood group O had a 20% reduced transplantation rate (SHR: 0.80, 95%CI: 0.75-0.85) and higher waitlist death/removal (1.33, 95%CI: 1.15-1.55) compared with group A. Blood group AB had a 52% higher transplantation rate (SHR: 1.52, 95%CI: 1.34-1.73) in the lowest LAS quartile compared with group A. In the highest LAS quartile, there was no difference in transplantation rates between groups O and A. In contrast, group B had a 19% reduced transplantation rate (SHR, 0.81 95%CI: 0.73-0.89) and AB had a 28% reduced transplantation rate (SHR: 0.72, 95%CI: 0.61-0.86) in the highest LAS quartile. Additionally, groups B and AB had increased risk of waitlist death/removal in the highest LAS quartile compared with A (SHR: 1.27, 95%CI: 1.08-1.48; SHR: 1.31, 95%CI: 1.00-1.72). CONCLUSIONS Waitlist outcomes among ABO blood groups vary depending on illness severity, which is represented by LAS. Blood group O has lower transplantation rates at low LAS while groups B and AB have lower transplantation rates at high LAS.
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Affiliation(s)
- Samantha Greissman
- Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Michaela Anderson
- Division of Pulmonary and Critical Care Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Angela Dimango
- Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University Irving Medical Center, New York, New York
| | - Harpreet Grewal
- Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University Irving Medical Center, New York, New York
| | - Gabriela Magda
- Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University Irving Medical Center, New York, New York
| | - Hilary Robbins
- Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University Irving Medical Center, New York, New York
| | - Lori Shah
- Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University Irving Medical Center, New York, New York
| | - Joseph Costa
- Department of Surgery, Columbia University Irving Medical Center, New York, New York
| | - Bryan Stanifer
- Department of Surgery, Columbia University Irving Medical Center, New York, New York
| | - Frank D'-Ovidio
- Department of Surgery, Columbia University Irving Medical Center, New York, New York
| | - Miguel Leiva Juarez
- Department of Surgery, Columbia University Irving Medical Center, New York, New York
| | - Philippe Lemaitre
- Department of Surgery, Columbia University Irving Medical Center, New York, New York
| | - Joshua Sonett
- Department of Surgery, Columbia University Irving Medical Center, New York, New York
| | - Selim Arcasoy
- Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University Irving Medical Center, New York, New York
| | - Luke Benvenuto
- Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University Irving Medical Center, New York, New York.
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