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The Impact of Donor Asphyxiation or Drowning on Pediatric Lung Transplant Recipients.
Seese, Laura; Kilic, Arman; Turbendian, Harma K; Sanchez, Pablo G; Diaz-Castrillon, Carlos E; Morell, Victor O.
Afiliação
  • Seese L; Division of Cardiac Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Kilic A; Division of Cardiac Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Turbendian HK; Division of Pediatric Cardiothoracic Surgery, University of Pittsburgh Medical Center, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA.
  • Sanchez PG; Division of Pediatric Cardiothoracic Surgery, University of Pittsburgh Medical Center, Wolfson Children's Hospital, Jacksonville, FL.
  • Diaz-Castrillon CE; Division of Lung Transplantation, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Morell VO; Division of Pediatric Cardiothoracic Surgery, University of Pittsburgh Medical Center, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA.
Transplantation ; 105(3): 620-627, 2021 03 01.
Article em En | MEDLINE | ID: mdl-32301909
BACKGROUND: Donors with drowning or asphyxiation (DA) as a mechanism of death (MOD) are considered high risk in pediatric lung transplantation. We sought to evaluate whether recipients of DA donors had negatively impacted outcomes. METHODS: Pediatric recipients recorded in the United Network for Organ Sharing registry between 2000 and 2019 were included. Primary stratification was donor MOD. Propensity matching with a 1:1 ratio was performed to balance the DA and non-DA MOD donor cohorts. Cox multivariable regression was used to determine the risk-adjusted impact of donor MOD. A subanalysis of the effect of lung allocation score was also evaluated. RESULTS: A total of 1016 patients underwent bilateral lung transplantation during the study period, including 888 (85.6%) from non-DA donors and 128 (14.4%) from DA donors. Survival at 90 days, 1 year, and 2 years were similar in the matched and unmatched cohorts regardless of the donor MOD. Moreover, separate risk-adjusted analysis of drowning and asphyxiated donors was similar to other MOD donors at 30 days, 1 year, and 5 years. Similar survival findings persisted regardless of pretransplant lung allocation score. Although the rates of posttransplant stroke (1.0% versus 3.1%, P = 0.04) and the length of hospital stay (19 versus 22 d, P = 0.004) were elevated in the unmatched DA MOD recipients, these differences were mitigated after propensity matching. CONCLUSIONS: This study evaluated the impact of DA MOD donors in pediatric lung transplant recipients and found similar rates of complications and survival in a propensity-matched cohort. These data collectively support the consideration of DA MOD donors for use in pediatric lung transplantation.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Asfixia / Doadores de Tecidos / Obtenção de Tecidos e Órgãos / Sistema de Registros / Transplante de Pulmão / Afogamento / Transplantados Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Female / Humans / Male Idioma: En Revista: Transplantation Ano de publicação: 2021 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Asfixia / Doadores de Tecidos / Obtenção de Tecidos e Órgãos / Sistema de Registros / Transplante de Pulmão / Afogamento / Transplantados Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Female / Humans / Male Idioma: En Revista: Transplantation Ano de publicação: 2021 Tipo de documento: Article País de publicação: Estados Unidos