Universität zu Köln

Zeriouh, Mohamed, Sabashnikov, Anton, Mohite, Prashant N., Zych, Bartlomiej, Patil, Nikhil P., Garcia-Saez, Diana, Koch, Achim, Weymann, Alexander, Soresi, Simona, Wippermann, Jens, Wahlers, Thorsten, De Robertis, Fabio, Popov, Aron-Frederik ORCID: 0000-0003-4226-3004 and Simon, Andre R. (2017). Zonal organ allocation system and its impact on long-term outcomes after lung transplantation: a propensity score matched analysis. Eur. J. Cardio-Thorac. Surg., 51 (1). S. 119 - 127. CARY: OXFORD UNIV PRESS INC. ISSN 1873-734X

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Abstract

OBJECTIVE: Zonal organ allocation system comprises organ procurement by teams within a specific geographical area of each retrieval team. Therefore, in a substantial number of cases organs are retrieved by 'foreign' teams and are sent for transplantation to the implanting centre. The aim of this study was to assess the impact of zonal organ allocation system on early-and long-term outcomes after lung transplantation (LTx). METHODS: Included were 331 consecutive patients who underwent LTx performed at Harefield Hospital between January 2007 and January 2015. Recipients were divided into two groups depending on the organ retrieval team: 204 (61.6%) patients were transplanted using lungs procured by our institutional team (institutional group), whereas 127 (38.4%) organs were retrieved by other teams (external group) from experienced transplant centres in the UK. To exclude selection bias and other confounders, a 1: 1 propensity score-based matching procedure was performed resulting in a total number of 238 donors and recipients who were well matched for baseline characteristics. The primary end-points were overall survival after LTx and freedom from bronchiolitis obliterans syndrome (BOS). Secondary end-points were perioperative clinical characteristics as well as adverse events that occurred over the follow-up. RESULT: After propensity score matching all donor characteristics and all baseline recipient characteristics were statistically similar between the two groups. In terms of early postoperative results, both groups were statistically comparable. However, there was a trend towards higher incidence of primary graft dysfunction in the external group (P = 0.054). Regarding long-term results with up to 7 years of follow-up, the overall survival also appeared to be poorer in the external group; however, this difference did not reach statistical significance. The freedom from BOS over the long-term follow was significantly poorer in the external group (P = 0.040). CONCLUSION: Despite excellent early outcomes the zonal allocation system might be associated with significantly poorer long-term outcomes in terms of freedom from BOS after bilateral LTx. Further research is needed to find the underlying factors leading to these results.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Zeriouh, Mohamed UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Mohite, Prashant N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zych, Bartlomiej UNSPECIFIED UNSPECIFIED UNSPECIFIED Patil, Nikhil P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Garcia-Saez, Diana UNSPECIFIED UNSPECIFIED UNSPECIFIED Koch, Achim UNSPECIFIED UNSPECIFIED UNSPECIFIED Weymann, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Soresi, Simona UNSPECIFIED UNSPECIFIED UNSPECIFIED Wippermann, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED De Robertis, Fabio UNSPECIFIED UNSPECIFIED UNSPECIFIED Popov, Aron-Frederik UNSPECIFIED orcid.org/0000-0003-4226-3004 UNSPECIFIED Simon, Andre R. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-246776
DOI:	10.1093/ejcts/ezw284
Journal or Publication Title:	Eur. J. Cardio-Thorac. Surg.
Volume:	51
Number:	1
Page Range:	S. 119 - 127
Date:	2017
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1873-734X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BRONCHIOLITIS-OBLITERANS-SYNDROME; PRIMARY GRAFT DYSFUNCTION; INTERNATIONAL-SOCIETY; AZITHROMYCIN THERAPY; CRITERIA; HEART; DONORS; DEATH Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24677