Featured articleEffect of ABO-Incompatible Listing on Infant Heart Transplant Waitlist Outcomes: Analysis of the United Network for Organ Sharing (UNOS) Database
Section snippets
Patient Population
After administrative review and approval by our institutional research ethics board, we retrospectively reviewed de-identified patient data extracted from the Organ Procurement and Transplantation Network (OPTN)/UNOS research database. We identified all infants aged younger than 12 months listed for primary heart transplantation between January 1, 2001, and May 20, 2008. Medical urgency as defined by UNOS includes status 1A (highest clinical acuity), 1B, and 2. Only patients designated at
Patient Demographics
As of May 20, 2008, 1,029 infants aged younger than 12 months were listed to undergo heart transplantation, and 277 (27%) were listed as eligible to receive an ABO-I organ. The percentage of infants during the study period listed as eligible to accept an ABO-I organ increased over time from 5.8% (9 of 154) in 2001 to 43.9% (65 of 148) in 2007. Baseline patient characteristics at the time of listing differed between groups. Infants listed as eligible for an ABO-I transplant were smaller by
Discussion
ABO-I heart transplantation for infants without established isohemagglutinin production is increasingly performed worldwide with favorable post-transplant outcomes.7, 13, 14 These favorable results led to the acceptance of ABO-I organ transplantation in 2001 by the UNOS, which governs transplantation in the United States. Our study shows that although the number of infants listed as eligible for ABO-I transplant in the United States has steadily increased, such that approximately half of all
Disclosure Statement
This work was supported in part by Health Resources and Services Administration contracts 231-00-0115 and 234-2005-370011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.
None of the authors has a financial relationship with a commercial entity that has an interest in the
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2012, Journal of Heart and Lung TransplantationCitation Excerpt :Data from the USA showed that there is a difference in listing times between children listed for ABOc and ABOi transplants. One study indicated that infants eligible for ABOi hearts have a median waiting time of 2 weeks less than those only listed for ABOc hearts.47 Another analysis showed a reduction in median waiting time (72 days for ABOc-listed patients compared with 54 days for ABOi-listed patients).49