Risky business: Taking the stigma out of high-risk donation in lung transplantation

Shelly Bansal*, Jeremiah Hayanga, John Odell, Dave Odell, Kwonho Jeong, Antonio Fabio, James Luketich, Jonathan D'Cunha

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background Outcomes data for high-risk donors (HRD) for transplantation are limited. We sought to elucidate the outcomes of lung transplant (LTx) recipients who received HRDs. Methods We retrospectively reviewed the United Network for Organ Sharing (UNOS) registry from January 2005 to June 2013 to identify patients undergoing LTx. The Student t test and χ2 test were used to identify differences in outcomes. A Cox proportional hazard model was developed to identify independent predictors of outcomes for HRD recipients. Results We identified 12,737 patients who underwent LTx. A total of 999 (7.8%) recipients received allografts from HRDs. Recipients in both the HRD and the non-HRD (NHRD) groups were similar. The HRDs had significantly higher rates of negative social behaviors and were likely to be thin young males who had died traumatically. Survival analysis demonstrated no survival benefit for patients receiving allografts from NHRDs (p = 0.63). Interestingly, HRDs did not have significantly higher viral loads, including hepatitis C virus (HCV) antibody, hepatitis B core antibody (HBcV), or hepatitis B surface antigen. When controlling for age, sex, and lung allocation score of the recipient, HRD status was not significantly detrimental to survival. Conclusions Recipients receiving allografts from HRDs had at least equivalent survival to NHRD recipients. Our study supports the use of high-risk donation given limited resources. Centers interested in using these donors should educate prospective recipients willing to consider this option.

Original languageEnglish (US)
Pages (from-to)1787-1794
Number of pages8
JournalAnnals of Thoracic Surgery
Issue number5
StatePublished - Nov 2015

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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