ArticleThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation2019
Implications of declining donor offers with increased risk of disease transmission on waiting list survival in lung transplantation.
Article in The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Hepatitis C Nucleic Acid Test Positive (NAT+) Solid Organ Consent Rates Are Highest in Patients Listed for Liver Transplant and With an English Language Preference.Clinical transplantation · 2025Article
- Aggressive pursuit and utilization of non-ideal donor lungs does not compromise post-lung transplant survival.Clinical transplantation · 2021Article
- A three-tier system for evaluation of organ procurement organizations' willingness to pursue and utilize nonideal donor lungs.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- Assessing Solid Organ Donors and Monitoring Transplant Recipients for Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Infection - U.S. Public Health Service Guideline, 2020.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2020Article
- Variability in donor organ offer acceptance and lung transplantation survival.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2020Article
- Expanding the donor pool for lung transplantation using HCV-positive donors.Journal of thoracic disease · 2019Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundDonors with characteristics that may increase the likelihood of disease transmission with transplantation are noted as increased risk via Public Health Service criteria. This study aimed to establish the implications of declining an increased-risk donor (IRD) organ offer in lung transplantation.
methodsAdult candidates waitlisted for isolated lung transplantation in the United States using the Organ Procurement and Transplantation Network /United Network of Organ Sharing registry from 2007 to 2017 were identified. Individual match run files identified candidate recipients who matched to an IRD offer. Competing-risks analysis ascertained the likelihood of survival to transplantation. A stratified Cox model and restricted mean survival times estimated the survival benefit associated with the acceptance of an IRD organ.
resultsA total of 6,963 candidates met inclusion criteria, and 1,473 (21.2%) accepted an IRD offer. Candidates who accepted an IRD offer were older, more likely to be male, and had a higher lung allocation score at the time of listing (all p < 0.05). At 1 year after an IRD offer decline, 70.5% of candidates underwent a lung transplant, 13.8% died or decompensated, and 14.9% were still awaiting transplant. Compared with those who declined, candidates who accepted the IRD offer had significantly improved cumulative mortality at 1 year (14.1% vs 23.9%, p < 0.001) and 5 years (48.4% vs 53.8%, p < 0.001).
conclusionsIRD organ declination is associated with a decreased rate of lung transplantation and worse survival. Overall post-transplant survival rates for those who survive to transplantation are equivalent.
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