Bilateral lung transplantation offers better long-term survival, compared with single-lung transplantation, for younger patients with idiopathic pulmonary fibrosis.
Bilateral lung transplantation offers better long-term survival, compared with single-lung transplantation, for younger patients with idiopathic pulmonary fibrosis.
复制标题
DOI：
10.1016/j.athoracsur.2010.08.055
复制
发表时间：
2011-01
期刊：
影响因子：
--
通讯作者：
Lawrence C
中科院分区：
文献类型：
--
作者：
Force SD;Kilgo P;Neujahr DC;Pelaez A;Pickens A;Fernandez FG;Miller DL;Lawrence C
对于继发于特发性肺纤维化的终末期肺病患者，单肺移植（CABG）和双侧肺移植（BLT）都是很好的选择。然而，目前还不清楚BLT是否比BLT提供任何生存优势。我们研究的目的是评估一个大的患者组，以确定是否有一个长期的生存优势，IPF患者的顺铂或BLT。这是机构审查委员会批准的对1987年至2008年器官共享联合网络数据库的回顾性分析。使用Kaplan-Meir估计确定生存率，通过考克斯比例风险和倾向分析确定偏侧性效应。在3，860例患者（2，431例SLT和1429例BLT）中进行了肺移植治疗特发性肺纤维化。多变量和倾向性分析未能显示BLT的任何生存优势（风险比= 0.90，95%置信区间= 0.78 - 1.0，p = 0.11）。1年条件生存率有利于BLT（风险比0.73，95%置信区间0.60 - 0.87，p = 0.00064）。早期死亡的危险因素包括受体年龄超过57岁和供体年龄超过36岁。对于患有特发性肺纤维化的年轻患者，应考虑双侧肺移植，并且当使用年轻供体时，结果可能会优化。
Single-lung transplantation (SLT) and bilateral lung transplantation (BLT) are both good options for patients with end-stage lung disease secondary to idiopathic pulmonary fibrosis. It is, however, unclear whether BLT offers any survival advantage over SLT. The purpose of our study was to evaluate a large group of patients to determine if either SLT or BLT officered a long-term survival advantage for patients with IPF. This was an Institutional Review Board-approved retrospective analysis of the United Network of Organ Sharing database from 1987 to 2008. Survival was determined using Kaplan-Meir estimates and the effect of laterality was determined by Cox proportional hazards and propensity analyses. Lung transplantation for idiopathic pulmonary fibrosis was performed in 3,860 patients (2,431 SLTs and 1429 BLTs). Multivariate and propensity analysis failed to show any survival advantage for BLT (hazard ratio = 0.90, 95% confidence interval = 0.78 to 1.0, p = 0.11). One-year conditional survival favored BLT (hazard ratio 0.73, 95% confidence interval 0.60 to 0.87, p = 0.00064). Risk factors for early death included recipient age over 57 and donor age over 36 years. Bilateral lung transplantation should be considered for younger patients with idiopathic pulmonary fibrosis and results may be optimized when younger donors are used.
登录
查看更多内容
影响因子：
6
作者：
Blackstone, EH
通讯作者：
Blackstone, EH
影响因子：
8.9
作者：
Christie, Jason D.;Edwards, Leah B.;Hertz, Marshall I.
通讯作者：
Hertz, Marshall I.
影响因子：
39.2
作者：
Thabut, Gabriel;Christie, Jason D.;Mal, Herve
通讯作者：
Mal, Herve
影响因子：
3.1
作者：
Neurohr, Claus;Huppmann, Patrick;Behr, Juergen
通讯作者：
Behr, Juergen
影响因子：
4.6
作者：
Weiss, Eric S.;Allen, Jeremiah G.;Shah, Ashish S.
通讯作者：
Shah, Ashish S.