Incidence and Outcomes of Simultaneous Thoracoabdominal Triple Organ Transplantation in the United States.


Journal

Transplantation proceedings
ISSN: 1873-2623
Titre abrégé: Transplant Proc
Pays: United States
ID NLM: 0243532

Informations de publication

Date de publication:
08 Jan 2024
Historique:
received: 17 09 2023
accepted: 30 11 2023
medline: 10 1 2024
pubmed: 10 1 2024
entrez: 9 1 2024
Statut: aheadofprint

Résumé

This study aims to evaluate patient outcomes of simultaneous triple organ transplants, which may provide insight into optimal donor allocation while maximizing recipient benefit. Triple organ transplants and their corollary dual organ transplants were identified using the United Network for Organ Sharing database. Triple organ transplants evaluated included heart-lung-kidney (n = 12) and heart-liver-kidney (n = 37). Heart-lung-kidney recipients were compared with heart-lung (n = 325), lung-kidney (n = 91), and heart-kidney (n = 2022) groups. Heart-liver-kidney recipients were compared with heart-liver (n = 451), liver-kidney (n = 10422), and heart-kidney (n = 2517) recipients. Patient survival outcomes were calculated using the Kaplan-Meier method and compared using log-rank tests. Patients undergoing triple organ transplants showed similar 10-year survival as their corresponding dual organ transplant cohorts. Patient survival estimate at 10 years for the heart-lung-kidney group was 45%, with no statistically significant difference in survival when compared with dual organ groups (P = .16). Survival estimates at 10 years for the heart-liver-kidney group was 49%, with no statistically significant difference in survival when compared with dual organ groups (P = .06). Despite the surgical burden of adding a third organ transplant, heart-liver-kidney and heart-lung-kidney have similar survival outcomes to dual organ equivalents and represent a reasonable allocation option in well-selected patients.

Sections du résumé

BACKGROUND BACKGROUND
This study aims to evaluate patient outcomes of simultaneous triple organ transplants, which may provide insight into optimal donor allocation while maximizing recipient benefit.
METHODS METHODS
Triple organ transplants and their corollary dual organ transplants were identified using the United Network for Organ Sharing database. Triple organ transplants evaluated included heart-lung-kidney (n = 12) and heart-liver-kidney (n = 37). Heart-lung-kidney recipients were compared with heart-lung (n = 325), lung-kidney (n = 91), and heart-kidney (n = 2022) groups. Heart-liver-kidney recipients were compared with heart-liver (n = 451), liver-kidney (n = 10422), and heart-kidney (n = 2517) recipients. Patient survival outcomes were calculated using the Kaplan-Meier method and compared using log-rank tests.
RESULTS RESULTS
Patients undergoing triple organ transplants showed similar 10-year survival as their corresponding dual organ transplant cohorts. Patient survival estimate at 10 years for the heart-lung-kidney group was 45%, with no statistically significant difference in survival when compared with dual organ groups (P = .16). Survival estimates at 10 years for the heart-liver-kidney group was 49%, with no statistically significant difference in survival when compared with dual organ groups (P = .06).
CONCLUSION CONCLUSIONS
Despite the surgical burden of adding a third organ transplant, heart-liver-kidney and heart-lung-kidney have similar survival outcomes to dual organ equivalents and represent a reasonable allocation option in well-selected patients.

Identifiants

pubmed: 38195284
pii: S0041-1345(23)00767-4
doi: 10.1016/j.transproceed.2023.11.029
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest All the authors declare no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Michie A Adjei (MA)

Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, United States.

Steven A Wisel (SA)

Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, United States.

Justin A Steggerda (JA)

Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, United States.

James Mirocha (J)

Biostatistics and Bioinformatics, Cedars-Sinai Medical Center, Los Angeles, California, United States.

Alisha Mavis (A)

Department of Pediatrics, Duke University, Durham, North Carolina, United States.

Carlos O Esquivel (CO)

Department of Surgery, Stanford University, Palo Alto, California, United States.

Irene K Kim (IK)

Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, United States. Electronic address: Irene.Kim@cshs.org.

Classifications MeSH