Reference : Impact of Donor, Recipient and Matching on Survival After High Emergency Lung Transpl...
Scientific journals : Article
Human health sciences : Surgery
http://hdl.handle.net/10993/42783
Impact of Donor, Recipient and Matching on Survival After High Emergency Lung Transplantation in France
English
Roussel, Arnaud [Hôpital Bichat, Université Paris-Diderot, INSERM 1152, Paris, France > > > ; Agence de la Biomédecine, Saint Denis, France]
Sage, Edouard [Hôpital Foch, Université Versailles-Saint-Quentin, Suresnes, France]
Massard, Gilbert mailto [University of Luxembourg > Faculty of Science, Technology and Communication (FSTC) > > ; Nouvel Hôpital Civil, CHU de Strasbourg, Strasbourg, France]
Thomas, Pascal-Alexandre [Hôpital Nord, CHU de Marseille, Marseille, France]
Castier, Yves [Hôpital Bichat, Université Paris-Diderot, INSERM 1152, Paris, France]
Fadel, Elie [Hôpital Marie-Lannelongue, Université Paris-Sud, Le Plessis Robinson, France]
Le Pimpec-Barthes, Françoise [Hôpital Européen Georges-Pompidou, Université Paris-Descartes, Paris, France]
Maury, Jean-Michel [Hôpital Louis-Pradel, CHU de Lyon, Lyon, France]
Jougon, Jacques [Hôpital du Haut Lévèque, CHU de Bordeaux, Pessac, France]
Lacoste, Philippe [Hôpital Nord-Laennec, CHU de Nantes, Nantes, France]
Claustre, Johanna [Hôpital Michallon, CHU de Grenoble, Grenoble, France]
Dahan, Marcel [Hôpital Larrey, CHU de Toulouse, Toulouse, France]
Pirvu, Augustin [Hôpital Michallon, CHU de Grenoble, Grenoble, France]
Tissot, Adrien [Hôpital Nord-Laennec, CHU de Nantes, Nantes, France]
Thumerel, Matthieu [Hôpital du Haut Lévèque, CHU de Bordeaux, Pessac, France]
Drevet, Gabrielle [Hôpital Louis-Pradel, CHU de Lyon, Lyon, France]
Pricopi, Ciprian [Hôpital Européen Georges-Pompidou, Université Paris-Descartes, Paris, France]
Le Pavec, Jérôme [Hôpital Marie-Lannelongue, Université Paris-Sud, Le Plessis Robinson, France]
Mal, Hervé [Hôpital Bichat, Université Paris-Diderot, INSERM 1152, Paris, France]
D'Journo, Xavier-Benoit [Hôpital Nord, CHU de Marseille, Marseille, France]
Kessler, Romain [Nouvel Hôpital Civil, CHU de Strasbourg, Strasbourg, France]
Roux, Antoine [Hôpital Foch, Université Versailles-Saint-Quentin, Suresnes, France]
Dorent, Richard [Agence de la Biomédecine, Saint Denis, France]
Thabut, Gabriel [Hôpital Bichat, Université Paris-Diderot, INSERM 1152, Paris, France]
Mordant, Pierre [Hôpital Bichat, Université Paris-Diderot, INSERM 1152, Paris, France]
7-Nov-2019
European Respiratory Journal
European Respiratory Society
Yes
International
0903-1936
1399-3003
Lausanne
United Kingdom
[en] Introduction: Since July 2007, the French high emergency lung transplantation (HELT) allocation procedure prioritises available lung grafts to waiting patients with imminent risk of death. The relative impacts of donor, recipient and matching on the outcome following HELT remain unknown. We aimed at deciphering the relative impacts of donor, recipient and matching on the outcome following HELT in an exhaustive administrative database.

Methods: All lung transplantations performed in France were prospectively registered in an administrative database. We retrospectively reviewed the procedures performed between July 2007 and December 2015, and analysed the impact of donor, recipient and matching on overall survival after the HELT procedure by fitting marginal Cox models.

Results: During the study period, 2335 patients underwent lung transplantation in 11 French centres. After exclusion of patients with chronic obstructive pulmonary disease/emphysema, 1544 patients were included: 503 HELT and 1041 standard lung transplantation allocations. HELT was associated with a hazard ratio for death of 1.41 (95% CI 1.22-1.64; p<0.0001) in univariate analysis, decreasing to 1.32 (95% CI 1.10-1.60) after inclusion of recipient characteristics in a multivariate model. A donor score computed to predict long-term survival was significantly different between the HELT and standard lung transplantation groups (p=0.014). However, the addition of donor characteristics to recipient characteristics in the multivariate model did not change the hazard ratio associated with HELT.

Conclusions: This exhaustive French national study suggests that HELT is associated with an adverse outcome compared with regular allocation. This adverse outcome is mainly related to the severity status of the recipients rather than donor or matching characteristics.
Researchers ; Professionals
http://hdl.handle.net/10993/42783
10.1183/13993003.00096-2019

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