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J Heart Lung Transplant. 2007 Jan;26(1):30-3.

Influence of blood group on mortality and waiting time before heart transplantation in the United kingdom: implications for equity of access.

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  • 1UK Transplant, Bristol, UK.

Abstract

BACKGROUND:

We examined waiting time for adult heart transplantation in the UK and sought to determine whether recipients with particular ABO blood groups were disadvantaged.

METHODS:

Data were obtained from the National Transplant Database. Registration outcome data were analyzed for 622 new, non-urgent, adult, heart-only registrations from April 1, 1999 to March 31, 2003. Unadjusted waiting times of the 618 first registrations were summarized using Kaplan-Meier estimates.

RESULTS:

Death rates were relatively low, with no significant difference in the proportions of patients among the different blood groups who died while waiting. A smaller proportion of blood group O patients were transplanted at 1 year after registration, with a significant difference in waiting time to transplant between blood groups (p < 0.0001). Blood group A and AB patients were generally transplanted sooner than O and B patients, with median waiting times of 81 days (95% CI: 67 to 114) and 76 days (95% CI: 52 to 178) vs 214 days (95% CI: 162 to 308) and 174 days (95% CI: 78 to 249), respectively.

CONCLUSIONS:

Although no particular blood group was disadvantaged in terms of mortality on the heart transplant list, blood group O and B patients waited significantly longer for transplantation. The difference was at least partly due to a large proportion of blood group O hearts being used for non-O patients. To address this imbalance, the UK Transplant Cardiothoracic Advisory Group (CTAG) changed the allocation protocol, so that "out-of-zone" offers of blood group O donors for non-urgent patients are now restricted to O and B recipients.

PMID:
17234514
[PubMed - indexed for MEDLINE]
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