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Published on: September 28, 2022
Heart transplantation with ABO-identical versus ABO-compatible cardiac grafts: influence on long-term survival
Johan Sjögren1, Fredrik Ljungdahl-Waller, Erik Senneby
1Department of Cardiothoracic Surgery, Lund University and Lund University Hospital, Lund, Sweden.
Insights
Identical ABO blood group matching in heart transplantation (HT) showed no significant survival difference compared to compatible matching. However, a trend suggested higher graft failure in compatible matches.
Area of Science:
- Cardiovascular Surgery
- Immunology
- Transplantation Medicine
Background:
- Heart transplantation (HT) outcomes are influenced by various factors, including immunological compatibility.
- ABO blood group matching is a critical consideration in organ transplantation.
Purpose of the Study:
- To evaluate the impact of identical versus compatible ABO blood group matching on rejection and long-term survival after heart transplantation.
- To identify factors affecting long-term survival in heart transplant recipients.
Main Methods:
- Retrospective analysis of 196 heart transplant recipients from 1988-2008.
- Cox proportional hazard regression analysis to determine factors associated with survival.
Main Results:
- No significant difference in long-term survival was observed between identical and compatible ABO blood group matches.
- Recipient blood group AB, age >55, longer ischemic time, and later transplantation year were associated with reduced survival.
- Glucocorticoids and cyclosporine improved overall survival.
Conclusions:
- Six factors influencing overall survival were identified, including recipient blood group AB.
- While no significant survival difference was found, a trend indicated higher graft failure in compatible ABO matches.
Objectives:
To compare identical versus compatible, ABO blood group matching effects on rejection and long-term survival after heart transplantation (HT).
Design:
Data were collected from 196 patients who underwent HT at Lund University Hospital between 1988 and 2008. Cox proportion hazard regression analysis was used to identify factors associated with reduced long-term survival.
Results:
One hundred and sixty six patients (85%) had an identical ABO blood group match and 30 patients (15%) had a compatible, ABO blood group match. Four non-pharmacological variables reducing overall survival were identified: recipient blood group AB, age >55 years, ischemic time, and year of transplantation. Two pharmacological variables improved overall survival: glucocorticoids and cyclosporine. There was no significant difference in long-term survival between patients with identical blood groups compared to compatible ABO blood group matching. However, there was a trend towards graft failure as cause of death being more common in the compatible ABO group match compared identical blood group match (13% versus 5%, p=0.118).
Conclusions:
Six factors associated with overall survival were identified. One of these was related to blood group AB. No significant difference in survival following identical, versus compatible, ABO matching was demonstrated.
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