TY - JOUR
T1 - Different-team procurements
T2 - A potential solution for the unintended consequences of change in lung allocation policy
AU - Yang, Zhizhou
AU - Gerull, William D.
AU - Shepherd, Hailey M.
AU - Marklin, Gary F.
AU - Takahashi, Tsuyoshi
AU - Meyers, Bryan F.
AU - Kozower, Benjamin D.
AU - Patterson, G. Alexander
AU - Nava, Ruben G.
AU - Hachem, Ramsey R.
AU - Witt, Chad A.
AU - Byers, Derek E.
AU - Vazquez Guillamet, Rodrigo
AU - Pasque, Michael K.
AU - Yan, Yan
AU - Kreisel, Daniel
AU - Puri, Varun
N1 - Publisher Copyright:
© 2021 The American Society of Transplantation and the American Society of Transplant Surgeons.
PY - 2021/9
Y1 - 2021/9
N2 - The new lung allocation policy has led to an increase in distant donors and consequently enhanced logistical burden of procuring organs. Though early single-center studies noted similar outcomes between same-team transplantation (ST, procuring team from transplanting center) and different-team transplantation (DT, procuring team from different center), the efficacy of DT in the contemporary era remains unclear. In this study, we evaluated the trend of DT, rate of transplanting both donor lungs, 1-year graft survival, and risk of Grade 3 primary graft dysfunction (PGD) using the Scientific Registry of Transplant Recipient (SRTR) database from 2006 to 2018. A total of 21619 patients (DT 2085, 9.7%) with 19837 donors were included. Utilization of DT decreased from 15.9% in 2006 to 8.5% in 2018. Proportions of two-lung donors were similar between the groups, and DT had similar 1-year graft survival as ST for both double (DT, HR 1.108, 95% CI 0.894–1.374) and single lung transplants (DT, HR 1.094, 95% CI 0.931–1.286). Risk of Grade 3 PGD was also similar between ST and DT. Given our results, expanding DT may be a feasible option for improving lung procurement efficiency in the current era, particularly in light of the COVID-19 pandemic.
AB - The new lung allocation policy has led to an increase in distant donors and consequently enhanced logistical burden of procuring organs. Though early single-center studies noted similar outcomes between same-team transplantation (ST, procuring team from transplanting center) and different-team transplantation (DT, procuring team from different center), the efficacy of DT in the contemporary era remains unclear. In this study, we evaluated the trend of DT, rate of transplanting both donor lungs, 1-year graft survival, and risk of Grade 3 primary graft dysfunction (PGD) using the Scientific Registry of Transplant Recipient (SRTR) database from 2006 to 2018. A total of 21619 patients (DT 2085, 9.7%) with 19837 donors were included. Utilization of DT decreased from 15.9% in 2006 to 8.5% in 2018. Proportions of two-lung donors were similar between the groups, and DT had similar 1-year graft survival as ST for both double (DT, HR 1.108, 95% CI 0.894–1.374) and single lung transplants (DT, HR 1.094, 95% CI 0.931–1.286). Risk of Grade 3 PGD was also similar between ST and DT. Given our results, expanding DT may be a feasible option for improving lung procurement efficiency in the current era, particularly in light of the COVID-19 pandemic.
KW - Scientific Registry for Transplant Recipients (SRTR)
KW - clinical research / practice
KW - lung transplantation / pulmonology
KW - organ procurement and allocation
KW - pulmonology, organ procurement
UR - http://www.scopus.com/inward/record.url?scp=85102319870&partnerID=8YFLogxK
U2 - 10.1111/ajt.16553
DO - 10.1111/ajt.16553
M3 - Article
C2 - 33638937
AN - SCOPUS:85102319870
SN - 1600-6135
VL - 21
SP - 3101
EP - 3111
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 9
ER -