Heart transplantation with ABO-identical versus ABO-compatible cardiac grafts: Influence on long-term survival.

Abstract Objectives. To compare identical versus compatible, ABO blood group matching effects on rejection and long-term survival after heart transplantation (HT). Design. Data were collected from 196 patients who underwent HT at Lund University Hospital between 1988 and 2008. Cox proportion hazard regression analysis was used to identify factors associated with reduced long-term survival. Results. One hundred and sixty six patients (85%) had an identical ABO blood group match and 30 patients (15%) had a compatible, ABO blood group match. Four non-pharmacological variables reducing overall survival were identified: recipient blood group AB, age >55 years, ischemic time, and year of transplantation. Two pharmacological variables improved overall survival: glucocorticoids and cyclosporine. There was no significant difference in long-term survival between patients with identical blood groups compared to compatible ABO blood group matching. However, there was a trend towards graft failure as cause of death being more common in the compatible ABO group match compared identical blood group match (13% versus 5%, p=0.118). Conclusions. Six factors associated with overall survival were identified. One of these was related to blood group AB. No significant difference in survival following identical, versus compatible, ABO matching was demonstrated.