Influence of graft ischemic time on outcomes following lung transplantation
Influence of graft ischemic time on outcomes following lung transplantation
复制标题
DOI：
10.1016/s1053-2498(01)00355-2
复制
发表时间：
2001-12-01
影响因子：
8.9
通讯作者：
Tribble, CG
中科院分区：
文献类型：
--
作者：
Fiser, SM;Kron, IL;Tribble, CG
背景：再灌注损伤是肺移植术后早期死亡的最常见原因。虽然冷移植物缺血时间已被报道影响这种损伤，一些缺血时间短的肺移植物发生显著的再灌注损伤，而其他移植物更长的缺血时间不发生损伤。我们的假设是缺血时间不会显着影响肺移植后的再灌注损伤或其他结果。方法：使用10年内接受肺移植的136名患者的数据进行分析。结果：冷移植物缺血时间大于或等于6小时不会增加再灌注损伤、急性排斥反应、巨细胞病毒、感染、细菌或真菌性肺炎的风险，闭塞性细支气管炎综合征、1个月死亡率、1年死亡率或5年死亡率，与缺血时间< 4小时或4 - 6小时相比。再灌注损伤的发生率至少为20%for each time group.Conclusions：至少有20%的所有患者将发展再灌注损伤，无论冷移植缺血时间。缺血时间延长至8小时不会导致短期、中期或长期不良结局显著增加。为了扩大供体肺库的地理范围，可能需要谨慎延长缺血时间，使其超过目前的目标4 - 6小时。
Background: Reperfusion injury is the most common cause of early mortality following lung transplantation. Although cold graft ischemic time has been reported to influence this injury, some lung grafts with short ischemic times develop significant reperfusion injury, whereas other grafts with more prolonged ischemic times do not develop injury. Our hypothesis was that ischemic time did not significantly influence reperfusion injury or other outcomes following lung transplantation.Methods: Data on 136 patients who had lung transplantation over a 10 year period was used for analysis.Results: Cold graft ischemic time greater than or equal to 6 hours did not increase the risk of reperfusion injury, acute rejection, cytomegalovirus,infection, bacterial or fungal pneumonia, bronchiolitis obliterans syndrome, 1-month mortality, I-year mortality, or 5-year mortality compared with ischemic times of either < 4 hours or 4 to 6 hours. The incidence of reperfusion injury was at least 20% for each time group.Conclusions: At least 20% of all patients will develop reperfusion injury regardless of cold graft ischemic time. Prolonged ischemic times up to 8 hours do not result in a significant increase in adverse short-term, intermediate, or long-term outcomes. Cautious extension of ischemic time beyond the current target of 4 to 6 hours may be warranted for geographic expansion of the donor lung pool.