Lung transplant for interstitial lung disease: outcomes before and after implementation of the united network for organ sharing lung allocation scoring system
Lung transplant for interstitial lung disease: outcomes before and after implementation of the united network for organ sharing lung allocation scoring system
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DOI：
10.1093/ejcts/ezr079
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发表时间：
2012-03-01
影响因子：
3.4
通讯作者：
Meyer, Keith C.
中科院分区：
文献类型：
--
作者：
De Oliveira, Nilto C.;Osaki, Satoru;Meyer, Keith C.
本研究旨在评估采用器官共享肺分配评分联合网络（LAS）是否与间质性肺病（ILD）患者肺移植（LTX）结局的显著变化相关在威斯康星州大学医院和诊所接受LTX的107名连续患者的结果，这些患者患有各种形式的ILD，在1993年1月至2004年3月期间接受LTX。2009年被审查。将LAS系统实施后移植的患者（LAS，n = 56）与LAS实施前移植的患者（LAS前，n = 51）进行比较，计算LAS评分。LAS实施后移植的受者年龄明显更大（LAS前：50.4 vs. LAS：56.7岁，P < 0.01），需要更多的补充氧气（3 vs. 5 l/min，P < 0.01），心脏指数值较低（3.1 vs. 2.6 l/m2，P < 0.01）。LAS评分由术前的38.3分提高到术前的43.3分，P < 0.01。但等待时间从266天减少到78天（P < 0.01）。LAS术后组的双侧LTX发生率低于单侧LTX发生率（35% vs. 16%，P = 0.02）。LAS术后冷缺血时间较短（434 vs. 299 min，P < 0.01），住院时间从24天缩短至11天（P < 0.01）。住院死亡率（11 vs. 7%，P = 0.51）和移植后生存率在两组之间没有差异，ILD患者或IPF受者亚组的移植后结局没有受到LAS实施的不利影响。
This study was undertaken to evaluate whether the adoption of the united network for organ sharing lung allocation score (LAS) was associated with significant changes in lung transplantation (LTX) outcomes for patients with interstitial lung disease (ILD) who underwent LTX at the University of Wisconsin Hospital and Clinics.Outcomes for 107 consecutive patients with various forms of ILD who underwent LTX between January 1993 and March 2009 were examined. Patients transplanted following the implementation of the LAS system (LAS, n = 56) were compared with those transplanted prior to LAS implementation (pre-LAS, n = 51) for whom LAS scores were calculated.Patients with idiopathic pulmonary fibrosis (IPF) comprised the majority of patients with ILD. Recipients transplanted after the implementation of the LAS were significantly older (pre-LAS: 50.4 vs. LAS: 56.7 years, P < 0.01), required more supplemental oxygen (3 vs. 5 l/min, P < 0.01) and displayed lower cardiac index values (3.1 vs. 2.6 l/m(2), P < 0.01). The estimated LAS was significantly increased from 38.3 (pre-LAS) to 43.3 (LAS), P < 0.01. However, waiting time decreased from 266 to 78 days (P < 0.01). The rate of bilateral vs. single LTX was lower (35 vs. 16%, P = 0.02) for the post-LAS group. Cold ischaemic time was shorter in the post-LAS group (434 vs. 299 min, P < 0.01), and the length of hospital stay decreased from 24 to 11 days (P < 0.01). Hospital mortality (11 vs. 7%, P = 0.51) and post-transplant survival did not differ between the groups.Post-transplant outcomes for patients with ILD or the subset of recipients with IPF were not adversely affected by the implementation of the LAS.