Epidemiology, risk factors, and outcomes of lung retransplantation: An analysis of the International Society for Heart and Lung Transplantation Thoracic Transplant Registry.
Epidemiology, risk factors, and outcomes of lung retransplantation: An analysis of the International Society for Heart and Lung Transplantation Thoracic Transplant Registry.
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DOI：
10.1016/j.healun.2022.06.022
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发表时间：
2022-10
影响因子：
8.9
通讯作者：
Cantu, Edward
中科院分区：
文献类型：
--
作者：
Harhay, Michael O.;Cherikh, Wida S.;Toll, Alice E.;Christie, Jason D.;Stehlik, Josef;Chambers, Daniel;Hayes Jr, Don;Cantu, Edward
再次肺移植是一个复杂的外科手术决定，是肺移植失败受者的唯一潜在治疗选择。我们试图描述肺再次移植的现代景观，并比较选择的临床，供体和受体因素对肺再次移植后一年死亡率的相对重要性。我们对2005年5月至2017年6月期间向国际心肺移植学会（ISHLT）胸移植登记处报告的死亡供体肺再移植的首次成人受者进行了一项回顾性队列研究。除了描述肺再移植受者的特征外，我们还检查了1年生存率，并通过初始移植-再移植程序类型、受者年龄、再移植适应症和肺再移植时间（即，移植间间隔）。我们使用索默斯的Dxy等级相关统计数据的审查，以评估几个潜在的预后危险因素的相对重要性，死亡率在肺再次移植后的一年。我们的队列包括1，597例肺再次移植受者。2005年是第一年超过100例再移植，自2007年以来，每年向ISHLT登记处报告138至188例再移植（约占所有移植的4-6%）。中位移植间隔为3.4年（四分位距：1.6 - 6.2年）。43%的患者有闭塞性细支气管炎再移植指征，而17%的患者有原发性移植物衰竭。三分之一（32%）在初次移植后2年内再次移植，64%两次接受双肺移植，而36%接受连续单肺移植。双肺-双肺再移植受者的6个月和1年生存率（82%和76%）高于单肺-单肺再移植受者（76%和69%）。1年死亡率的三个最强预后因素是移植间隔时间（间隔时间越长，风险越小）、供体年龄（年龄越大，风险越大）和再次肺移植前是否需要机械通气。再移植约占全球每年肺移植的5%。在这一人群中，与1年死亡率最密切相关的因素是初次肺移植后的持续时间，随着时间的推移，风险持续降低。
Lung retransplantation is a complex surgical decision that represents the only potential treatment option for recipients suffering from lung allograft failure. We sought to describe the modern landscape of lung retransplantation and to compare the relative importance of selected clinical, donor, and recipient factors on mortality in the year following lung retransplantation. We conducted a retrospective cohort study of first-time adult recipients of deceased donor lung retransplants reported to the International Society for Heart and Lung Transplantation (ISHLT) Thoracic Transplant Registry from May 2005 through June 2017. In addition to describing the characteristics of lung retransplant recipients, we examined 1-year survival overall, and by initial transplant-retransplant procedure type, recipient age, retransplant indication, and time-to-lung retransplantation (i.e., inter-transplant interval). We used the Somers’ Dxy rank correlation statistic for censored data to assess the relative importance of several potential prognostic risk factors for mortality in the year following lung retransplantation. Our cohort included 1,597 lung retransplant recipients. 2005 was the first year with more than 100 retransplants, and since 2007, 138 to 188 retransplants (approximately 4-6% of all transplants) were reported annually to the ISHLT Registry. The median inter-transplant interval was 3.4 years (interquartile range: 1.6 to 6.2 years). Forty-three percent of the cohort had an obliterative bronchiolitis retransplant indication, whereas 17% had primary graft failure. One-third (32%) were retransplanted within 2 years of their primary transplant, and 64% received a double lung transplant both times, whereas 36% received consecutive single lung transplants. Six-month and 1-year survival (82% and 76%) were higher for double-double lung retransplant recipients than for single-single recipients (76% and 69%). The three strongest prognostic factors for 1-year mortality were the inter-transplant interval (decreasing hazard with longer intervals), donor age (increasing hazard with older age), and need for mechanical ventilation preceding lung retransplantation. Retransplants comprise approximately 5% of annual lung transplants worldwide. The factor most strongly associated with 1-year mortality in this population was the duration of time since the primary lung transplant, with a persistent reduction in risk as more time elapses.
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DOI：
10.1016/j.athoracsur.2021.03.112
发表时间：
2022-04
期刊：
The Annals of thoracic surgery
影响因子：
--
作者：
Randhawa SK;Yang Z;Morkan DB;Yan Y;Chang SH;Hachem RR;Witt CA;Byers DE;Kulkarni HS;Guillamet RV;Kozower BD;Nava RG;Meyers BF;Patterson GA;Kreisel D;Puri V
通讯作者：
Puri V
影响因子：
5.4
作者：
GREENLAND, S
通讯作者：
GREENLAND, S
影响因子：
8.9
作者：
Chambers, Daniel C.;Cherikh, Wida S.;Stehlik, Josef
通讯作者：
Stehlik, Josef
影响因子：
4.6
作者：
Hall, David J.;Belli, Erol V.;Machuca, Tiago N.
通讯作者：
Machuca, Tiago N.
DOI：
10.1164/rccm.200707-1132oc
发表时间：
2008-01-01
影响因子：
24.7
作者：
Kawut, Steven M.;Lederer, David J.;Barr, Mark L.
通讯作者：
Barr, Mark L.