BACKGROUND: The purported advantage of ABO-incompatible (ABO-I) listing is to reduce wait times and wait-list mortality among infants awaiting heart transplantation. We sought to describe recent trends in ABO-I listing for US infants and to determine the impact of ABO-I listing on wait times and wait-list mortality. METHODS AND RESULTS: In this multicenter retrospective cohort study using Organ Procurement and Transplant Network data, infants<12 months of age listed for heart transplantation between 1999 and 2008 (n=1331) were analyzed. Infants listed for an ABO-I transplant were compared with a propensity score-matched cohort listed for an ABO-compatible transplant through the use of a Cox shared-frailty model. The primary end point was time to heart transplantation. The percentage of eligible infants listed for an ABO-I heart increased from 0% before 2002 to 53% in 2007 (P<0.001 for trend). Compared with infants listed exclusively for an ABO-compatible heart, infants with a primary ABO-I listing strategy (n=235) were more likely to be listed 1A, to have congenital heart disease and renal failure, and to require extracorporeal membrane oxygenation. For the propensity score-matched groups (n=197 matched pairs), there was no difference in wait-list mortality; however, infants with blood type O assigned an ABO-I listing strategy were more likely to undergo heart transplantation by 30 days (31% versus 16%; P=0.007) with a less pronounced effect for infants with other blood types. CONCLUSIONS: The proportion of US infants listed for an ABO-I heart transplantation has risen dramatically in recent years but still appears to be preferentially used for sicker infant candidates. The ABO-I listing strategy is associated with a higher likelihood of transplantation within 30 days for infants with blood group O and may benefit a broader range of transplantation candidates.
BACKGROUND: The purported advantage of ABO-incompatible (ABO-I) listing is to reduce wait times and wait-list mortality among infants awaiting heart transplantation. We sought to describe recent trends in ABO-I listing for US infants and to determine the impact of ABO-I listing on wait times and wait-list mortality. METHODS AND RESULTS: In this multicenter retrospective cohort study using Organ Procurement and Transplant Network data, infants<12 months of age listed for heart transplantation between 1999 and 2008 (n=1331) were analyzed. Infants listed for an ABO-I transplant were compared with a propensity score-matched cohort listed for an ABO-compatible transplant through the use of a Cox shared-frailty model. The primary end point was time to heart transplantation. The percentage of eligible infants listed for an ABO-I heart increased from 0% before 2002 to 53% in 2007 (P<0.001 for trend). Compared with infants listed exclusively for an ABO-compatible heart, infants with a primary ABO-I listing strategy (n=235) were more likely to be listed 1A, to have congenital heart disease and renal failure, and to require extracorporeal membrane oxygenation. For the propensity score-matched groups (n=197 matched pairs), there was no difference in wait-list mortality; however, infants with blood type O assigned an ABO-I listing strategy were more likely to undergo heart transplantation by 30 days (31% versus 16%; P=0.007) with a less pronounced effect for infants with other blood types. CONCLUSIONS: The proportion of US infants listed for an ABO-I heart transplantation has risen dramatically in recent years but still appears to be preferentially used for sicker infant candidates. The ABO-I listing strategy is associated with a higher likelihood of transplantation within 30 days for infants with blood group O and may benefit a broader range of transplantation candidates.
Authors: Lori J West; Tara Karamlou; Anne I Dipchand; Stacey M Pollock-BarZiv; John G Coles; Brian W McCrindle Journal: J Thorac Cardiovasc Surg Date: 2006-02 Impact factor: 5.209
Authors: Sabine H Daebritz; Michael Schmoeckel; Helmut Mair; Rainer Kozlik-Feldmann; Georg Wittmann; Christian Kowalski; Ingo Kaczmarek; Bruno Reichart Journal: Eur J Cardiothorac Surg Date: 2007-01-17 Impact factor: 4.191
Authors: Christopher S D Almond; Ravi R Thiagarajan; Gary E Piercey; Kimberlee Gauvreau; Elizabeth D Blume; Heather J Bastardi; Francis Fynn-Thompson; T P Singh Journal: Circulation Date: 2009-01-26 Impact factor: 29.690
Authors: Douglas Mah; Tajinder P Singh; Ravi R Thiagarajan; Kimberlee Gauvreau; Gary E Piercey; Elizabeth D Blume; Francis Fynn-Thompson; Christopher S D Almond Journal: J Heart Lung Transplant Date: 2009-09-26 Impact factor: 10.247
Authors: Eric J Wright; William P Fiser; R Erik Edens; Elizabeth A Frazier; W Robert Morrow; Michiaki Imamura; Robert D B Jaquiss Journal: J Heart Lung Transplant Date: 2007-09-27 Impact factor: 10.247
Authors: S L Roche; M Burch; J O'Sullivan; J Wallis; G Parry; R Kirk; M Elliot; N Shaw; J Flett; J R L Hamilton; A Hasan Journal: Am J Transplant Date: 2007-11-12 Impact factor: 8.086
Authors: Nishant D Patel; Eric S Weiss; Janet Scheel; Duke E Cameron; Luca A Vricella Journal: J Heart Lung Transplant Date: 2008-10 Impact factor: 10.247
Authors: Jagan N Rao; Asif Hasan; John R L Hamilton; David Bolton; Simon Haynes; Johnathan H Smith; Jonathan Wallis; Patrick Kesteven; Kamran Khattak; John O'Sullivan; John H Dark Journal: Transplantation Date: 2004-05-15 Impact factor: 4.939
Authors: Daniel Westreich; Stephen R Cole; Michele Jonsson Funk; M Alan Brookhart; Til Stürmer Journal: Pharmacoepidemiol Drug Saf Date: 2010-12-09 Impact factor: 2.890
Authors: Dala Zakaria; Elizabeth Frazier; Michiaki Imamura; Xiomara Garcia; Sherry Pye; Kenneth R Knecht; Parthak Prodhan; Jeffrey R Gossett; Christopher J Swearingen; W Robert Morrow Journal: Pediatr Cardiol Date: 2016-11-01 Impact factor: 1.655