Journal article
Massive donor transfusion potentially increases recipient mortality after lung transplantation
The Journal of thoracic and cardiovascular surgery, v 153(5), pp 1197-1203
May 2017
PMID: 28073574
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Donor blood transfusion has been identified as a potential risk factor for primary graft dysfunction and by extension early mortality. We sought to define the contributing risk of donor transfusion on early mortality for lung transplant.
Donor and recipient data were abstracted from the Organ Procurement and Transplantation Network database updated through June 30, 2014, which included 86,398 potential donors and 16,255 transplants. Using the United Network for Organ Sharing 4-level designation of transfusion (no blood, 1-5 units, 6-10 units, and >10 units, massive), we analyzed all-cause mortality at 30-days with the use of logistic regression adjusted for confounders (ischemic time, donor age, recipient diagnosis, lung allocation score and recipient age, and recipient body mass index). Secondary analyses assessed 90-day and 1-year mortality and hospital length of stay.
Of the 16,255 recipients transplanted, 8835 (54.35%) donors received at least one transfusion. Among those transfused, 1016 (6.25%) received a massive transfusion, defined as >10 units. Those donors with massive transfusion were most commonly young trauma patients. After adjustment for confounding variables, donor massive transfusion was associated significantly with an increased risk in 30-day (P = .03) and 90-day recipient mortality (P = .01) but not 1-year mortality (P = .09). There was no significant difference in recipient length of stay or hospital-free days with respect to donor transfusion.
Massive donor blood transfusion (>10 units) was associated with early recipient mortality after lung transplantation. Conversely, submassive donor transfusion was not associated with increased recipient mortality. The mechanism of increased early mortality in recipients of lungs from massively transfused donors is unclear and needs further study but is consistent with excess mortality seen with primary graft dysfunction in the first 90 days posttransplant.
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Details
- Title
- Massive donor transfusion potentially increases recipient mortality after lung transplantation
- Creators
- Catherine F. Borders - University of PennsylvaniaYoshikazu Suzuki - University of PennsylvaniaJared Lasky - University of PennsylvaniaChristian Schaufler - University of PennsylvaniaDjamila Mallem - University of PennsylvaniaJames Lee - University of PennsylvaniaKevin Carney - University of PennsylvaniaScarlett L. Bellamy - University of PennsylvaniaChristian A. Bermudez - University of PennsylvaniaA. Russell Localio - University of PennsylvaniaJason D. Christie - University of PennsylvaniaJoshua M. Diamond - University of PennsylvaniaEdward Cantu - University of Pennsylvania
- Publication Details
- The Journal of thoracic and cardiovascular surgery, v 153(5), pp 1197-1203
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000402474500051
- Scopus ID
- 2-s2.0-85009210482
- Other Identifier
- 991019298604104721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Respiratory System
- Surgery