Blood group A2 to blood group O kidney and liver transplants have been shown to be safe and successful, especially in recipients with low pre-operative anti-A antibody titers and with the use of peri-operative antibody-depleting therapies. Since blood group O lung transplant candidates tend to have longer wait times and a higher waitlist mortality compared to other blood groups, we propose to conduct a prospective study of lung transplantation from blood group A2 donors to eligible blood group O recipients in an effort to increase the available donor pool. The aim of this study is to determine both the feasibility and safety of this specific type of ABO-incompatible lung transplant, and the impact of this practice on reducing transplant wait times among blood group O lung transplant candidates. This would represent the first prospective study of ABO-incompatible lung transplants worldwide.
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Post-transplant anti-A antibody titers
Timeframe: post-op day 5 or day 12
Primary graft dysfunction grade
Timeframe: post-op day 0, 1, 2, 3
Incidence of hyperacute antibody-mediated rejection
Timeframe: post-op day 1, 2
C4d positivity on transbronchial biopsy samples
Timeframe: 1 year
Incidence and severity of acute cellular rejection
Timeframe: 1 year
Bleeding
Timeframe: post-op day 1-7
Infection
Timeframe: 10 years
Graft function
Timeframe: 10 years
Incidence of malignancy
Timeframe: 10 years
Chronic lung allograft dysfunction
Timeframe: 10 years
Time to death or re-transplantation
Timeframe: 10 years