Differential effects of donor factors on post-transplant survival in lung transplantation

Background: Predicting post-transplant (PT) survival in lung allocation remains an elusive goal. We analyzed the impact of donor factors on PT survival and how these relationships vary among transplant recipients. Methods: We studied primary bilateral lung transplant recipients (n = 7,609) from the...

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Bibliographic Details
Published in:JHLT Open 2024-08, Vol.5, p.100122, Article 100122
Main Authors: Lehr, Carli J., Dalton, Jarrod E., Dewey, Elizabeth N., Gunsalus, Paul R., Rose, Johnie, Valapour, Maryam
Format: Article
Language:English
Subjects:
donor utilization
lung transplant
organ allocation
post-transplant survival
risk assessment
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Summary:Background: Predicting post-transplant (PT) survival in lung allocation remains an elusive goal. We analyzed the impact of donor factors on PT survival and how these relationships vary among transplant recipients. Methods: We studied primary bilateral lung transplant recipients (n = 7,609) from the US Scientific Registry of Transplant Recipients (19 February 2015-1 February 2020). Main and interaction effects were evaluated and adjusted across candidate age, sex, and diagnosis. Models predicting PT survival were compared to the PT Composite Allocation Score model (PT-CAS): (1) Cox regression donor multivariable model (COX), (2) COX + PT-CAS, (3) random forest model (RF), and (4) RF + PT-CAS. Model discrimination and calibration measures were compared. Results: Interactions between donor and recipient factors emerged by age: lower survival for donation after circulatory death organs for recipients aged 55 to 69 years, donor smoking for recipients aged 30 to 54 and 70+, Hispanic donor for recipients
ISSN:2950-1334
2950-1334
DOI:10.1016/j.jhlto.2024.100122