6. Influence of graft ischemic time and geographic distance between donor and recipient on survival in children after lung transplantation

HAYES et al, 2016
J Heart Lung Transplant. 2016 May 27. pii: S1053-2498(16)30143-7. doi: 10.1016/j.healun.2016.05.018. [Epub ahead of print]
Hayes D1, Joy BF2, Reynolds SD3, Tobias JD4, Tumin D5. ( Section of Pulmonary Medicine, Nationwide Children’s Hospital, Columbus, Ohio, USA. Electronic address: hayes.705@osu.edu.


The optimal ischemic time in pediatric lung transplantation (LTx) is unclear, as recent studies have challenged the relevance of 6 hours as an upper limit to acceptable ischemic time.


Pediatric LTx recipients transplanted between 1987 and 2013 were identified in the United Network for Organ Sharing (UNOS) registry to compare survival according to ischemic time, which was categorized as 6 hours.


930 patients, all 6 hours (HR = 0.985; 95% CI 0.755 to 1.284; p = 0.909). A
multivariate Cox model confirmed the lowest mortality hazard to be 4 to 6 hours, as compared with 6 hours was associated with increased mortality hazard relative to the 4 to 6 hours (HR = 1.613; 95% CI 1.193 to 2.181; p = 0.002). Supplementary analyses examining geographic distance between donor and recipient identified no association between geographic distance and recipient mortality hazard.


An ischemic time of 4 to 6 hours was associated with optimal long-term survival in first-time pediatric LTx recipients, whereas a very short ischemic time of 6 hours were both associated with higher mortality hazard in this population.

Copyright © 2016 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved. KEYWORDS: donor; geographic distance; ischemic time; lung transplantation; recipient; survival. PMID:27373823 DOI: 10.1016/j.healun.2016.05.018 [PubMed – as supplied by publisher]