Lung Transplant Outcomes in White and African American Recipients: Special Focus on Acute and Chronic Rejection

Impact of Donor–Recipient Race Matching on Survival After Lung Transplantation: Analysis of Over 11,000 Patients

“…Similar to findings by Lingaraju and colleagues, 20 we observed no survival differences based on recipient race; however, there were significant decreases in survival for patients who received African American donor lungs. This intriguing finding has been observed in other studies examining lung, 21 liver, 14 kidney 11 and a mixed cohort of solid-organ transplant patients.…”

“…It must be noted, however, that UNOS follow-up on secondary outcomes (e.g., rejection) is less complete than its survival data. 20 As noted by Christie and colleagues, 21 there is an increase in the rate of primary graft dysfunction (PGD) in recipients of African American donor lungs. Because PGD manifests shortly after transplant, this is a potential mediator of the race-matching effect.…”

“…However, their study's statistical power was limited by the small number of African American recipients. 20 Our study has built upon the work of these investigators using a multi-institutional modern cohort. This series provides a snapshot of the modern practice of LTx in the USA and shows that donor-recipient race matching impacts survival, with the effect manifesting in the first 2 post-LTx years.…”

Anti-human leukocyte antigen antibodies and preemptive antibody-directed therapy after lung transplantation

“…Bronchiolitis obliterans syndrome (BOS) has emerged as the primary obstacle to better long-term outcomes. Indeed, the incidence of BOS is approximately 40–50% within three years of transplantation (2, 3). More importantly, the median survival after the diagnosis of BOS is only three years (4).…”

Racial Disparities in Survival After Lung Transplantation

“…[9][10][11][12][13][14][15] Among patients with end-stage lung disease, blacks have worse survival than whites while on the lung transplant waiting list. 16,17 Recent reports, [17][18][19] however, suggest that they have similar survival after transplantation. No study has examined racial disparities in survival after lung transplant in a historical context.…”