ArticleTransplant international : official journal of the European Society for Organ Transplantation2026
Identical versus compatible blood typing: investigating best practices in lung transplantation.
Article in Transplant international : official journal of the European Society for Organ Transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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13 authors.
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Abstract
This study investigated acute rejection in ABO-compatible versus ABO-identical lung transplants from 2005-2023, with a secondary objective of comparing 5-year survival. Lung transplantation improves quality of life and survival; however, organ scarcity remains a major challenge. While ABO-identical matching has traditionally been preferred, evolving allocation policies and research have increased the use of ABO-compatible transplants to expand the donor pool. A retrospective cohort study using the UNOS database included adult recipients (n = 32,761). Comparisons were made between ABO-identical (n = 30,347) and ABO-compatible (n = 2,414) groups. Logistic regression assessed acute rejection, and Kaplan-Meier and Cox proportional hazards models evaluated 5-year survival. There was no significant difference in acute rejection (p = 0.99; OR = 1.03, 95% CI 0.86-1.21). ABO-identical transplants showed improved 5-year survival (p = 0.019; HR = 0.91, 95% CI 0.85-0.98), with benefits limited to recipients with obstructive lung disease (p = 0.043) and those in the highest LAS quartile (p = 0.014). The differential benefit of this modest association between ABO-identical matching and survival in this subpopulation remains unclear. Overall, ABO-compatible transplantation safely expands donor availability without increasing rejection risk.
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