Background: Rare blood types (B and AB) are increasingly a risk factor for lung transplant waitlist mortality when compared to common blood types (A and O) in national registry data. We examined our center experience and hypothesized rare blood types (B or AB), when compared to common blood types (A and O), received fewer local donors and therefore depend more on non-local donors in order to access lung transplant.

Methods: Retrospective single center cohort study of adult (≥18 years) first time lung only transplants from January 1, 2009 until December 31, 2016. The four ABO blood types were A, B, AB, and O. We also assessed waitlist mortality. Donor location relative to our center was defined as local vs non-local (inside vs outside the Donor Service Area boundaries). Categorical variables were assessed with chi-square tests, continuous variables with one-way ANOVA, and post-transplant survival with Kaplan-Meier survival estimates. p ≤0.05 was significant.

Results: 854 recipients met inclusion criteria with 38%, 13%, 4%, and 45% having A, B, AB, and O blood types, respectively. B and AB blood types were less likely to receive local donor lungs (14% and 8%, respectively), compared to A and O blood types (30% and 32%, respectively) (p <0.001). B and AB blood types had shorter average waitlist times (91 and 63 days, respectively) compared to A and O blood types (183 days) (p <0.001). There were no significant differences among ABO blood types by native lung disease, bilateral vs single lung transplant, or one year post-transplant survival. There were compatible matches in 1.5% of A, 19% in AB, and 0% in B and O blood types; the remainder were identical ABO donor/recipient matches. In a separate analysis of 1,256 waitlisted patients, waitlist mortality did not significantly differ by blood type (p = 0.61).

Discussion: Waitlist mortality was not significantly different by blood type at our center, which differs from trends in national registry data. At our center, patients with rare blood types (B or AB), when compared to common blood types (A and O), received significantly fewer local donors and also had shorter waitlist times. The finding that rare blood types rely on broader geographic regions to access donor lungs, which likely contributed to shorter waitlist times and a waitlist mortality comparable to common blood types, should be explored further. There may be a role for broader geographic sharing to help increase access to lung transplant.

CITATION INFORMATION: Tsuang W., McMichael D., Wang X., Budev M. The Impact of ABO Blood Type and Geography on Access to Lung Transplant Am J Transplant. 2017;17 (suppl 3).

« Back to 2018 American Transplant Congress