The eurotransplant study on twin lung transplants (ESOTWIN): 90 paired single-lung transplants from the same donor
The eurotransplant study on twin lung transplants (ESOTWIN): 90 paired single-lung transplants from the same donor
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DOI：
10.1097/01.tp.0000092312.54304.b0
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发表时间：
2003-12-15
期刊：
影响因子：
6.2
通讯作者：
Van Raemdonck, D
中科院分区：
文献类型：
--
作者：
Smits, JMA;Melman, S;Van Raemdonck, D
背景尽管其减少了单个受体的益处，但与一个双侧肺移植相比，两个单肺同种异体移植物的移植具有最大化受益于单个供体的患者数量的无可争议的优势。从1997年到1999年，在欧洲16个肺移植中心进行了45例供体的90例配对单肺移植（SLTx），随访1年。左肺和右肺同种异体移植受者之间在年龄、性别、原发病、人类白细胞抗原错配数量、冷缺血时间和供体与受体巨细胞病毒匹配方面没有观察到显著差异。移植后早期结果，在12，24和48小时的氧合指数评估，也没有显着差异，拔管时间和在重症监护室的时间没有差异。在第一个月，6名左肺和3名右肺移植受者死亡。39例左肺移植受者中有5例发生闭塞性细支气管炎综合征，42例右肺移植受者中有10例发生闭塞性细支气管炎综合征。如果取出组与移植组不同，则接受左侧SLTx的患者的移植后1年生存率明显低于接受右侧SLTx的患者（分别为62%和92%; P = 0.04）。接受左侧SLTx的患者比接受右侧SLTx的患者发生更多致命的移植后并发症。非植入回收团队对左肺的评估不太乐观。
Background. Despite its reduced benefit for a single recipient, the transplantation of two single-lung allografts as opposed to one bilateral lung transplant has the indisputable advantage of maximizing the number of patients that benefit from a single donor.Methods. In the period 1997 to 1999, 90 paired single-lung transplants (SLTx) from 45 donors were performed in 16 lung centers in Eurotransplant, with a complete follow-up of 1 year.Results. No significant differences between left- and right-lung allograft recipients were observed regarding age, sex, primary disease, number of human leukocyte antigen mismatches, cold ischemic time, and donor-to-recipient cytomegalovirus match. Early posttransplant outcome, as assessed by oxygenation index at 12, 24, and 48 hr, also did not differ significantly, and there were no differences in time to extubation and time spent in the intensive care unit. In the first month, six left- and three right-lung allograft recipients died. Bronchiolitis obliterans syndrome developed in 5 of 39 left-lung and 10 of 42 right-lung allograft recipients. If the retrieval team was different from the transplanting team, a significantly worse 1-year posttransplant survival rate was seen in patients who underwent left SLTx compared with those who underwent right SLTx (62% vs. 92%, respectively; P = 0.04).Conclusions. More fatal posttransplant complications occur in patients undergoing left SLTx compared with right SLTx. A less optimistic assessment of the left lung by the not-implanting retrieval team is warranted.