Journal article
Donor to recipient sizing in thoracic organ transplantation
World journal of transplantation, Vol.6(1), pp.155-164
03/24/2016
DOI: 10.5500/wjt.v6.i1.155
PMCID: PMC4801791
PMID: 27011913
Abstract
Donor-to-recipient organ size matching is a critical aspect of thoracic transplantation. In the United States potential recipients for lung transplant and heart transplant are listed with limitations on donor height and weight ranges, respectively. Height is used as a surrogate for lung size and weight is used as a surrogate for heart size. While these measures are important predictors of organ size, they are crude surrogates that fail to incorporate the influence of sex on organ size. Independent of other measures, a man's thoracic organs are approximately 20% larger than a woman's. Lung size can be better estimated using the predicted total lung capacity, which is derived from regression equations correcting for height, sex and age. Similarly, heart size can be better estimated using the predicted heart mass, which adjusts for sex, age, height, and weight. These refined organ sizing measures perform better than current sizing practice for the prediction of outcomes after transplantation, and largely explain the outcome differences observed after sex-mismatch transplantation. An undersized allograft is associated with worse outcomes. In this review we examine current data pertaining to size-matching in thoracic transplantation. We advocate for a change in the thoracic allocation mechanism from a height-or-weight-based strategy to a size-matching process that utilizes refined estimates of organ size. We believe that a size-matching approach based on refined estimates of organ size would optimize outcomes in thoracic transplantation without restricting or precluding patients from thoracic transplantation.
Details
- Title: Subtitle
- Donor to recipient sizing in thoracic organ transplantation
- Creators
- Michael Eberlein - Michael Eberlein, Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United StatesRobert M Reed - Michael Eberlein, Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States
- Resource Type
- Journal article
- Publication Details
- World journal of transplantation, Vol.6(1), pp.155-164
- DOI
- 10.5500/wjt.v6.i1.155
- PMID
- 27011913
- PMCID
- PMC4801791
- ISSN
- 2220-3230
- eISSN
- 2220-3230
- Grant note
- UL1 TR000442 / NCATS NIH HHS P30 DK054759 / NIDDK NIH HHS
- Language
- English
- Date published
- 03/24/2016
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984094518602771
Metrics
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