Impact of Spousal Donation on Postoperative Outcomes of Living-donor Lobar Lung Transplantation
Impact of Spousal Donation on Postoperative Outcomes of Living-donor Lobar Lung Transplantation
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配偶捐献对活体肺叶肺移植术后效果的影响
DOI：
10.1097/tp.0000000000004579
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发表时间：
2023
期刊：
影响因子：
6.2
通讯作者：
Date Hiroshi
中科院分区：
文献类型：
--
作者：
Kayawake Hidenao;Tanaka Satona;Yutaka Yojiro;Yamada Yoshito;Ohsumi Akihiro;Hamaji Masatsugu;Nakajima Daisuke;Yurugi Kimiko;Hishida Rie;Date Hiroshi
背景：供者和受者之间人类白细胞抗原不匹配对肺移植术后结果的影响仍然存在争议。我们回顾了接受活体供肺叶肺移植(LDLLT)的成人受者，以检测配偶(非血亲)和非配偶(三级亲属)供者的移植肺在发生新的供者特异性抗体(DnDSA)和临床诊断的单侧慢性移植肺功能障碍(单侧CLAD)方面的差异。我们还调查了包括配偶供者(配偶供者)和不包括配偶供者(非配偶供者)的接受LDLLTS的受者之间的预后差异。方法：在这项研究中，从2008年到2020年，63例接受LDLLTS的成人受者(来自124名在世供者的61例双侧和2例单侧)接受了LDLLT。结果：配偶和非配偶供者移植肺的dnDSA和单侧包膜的累积发生率均显著高于非配偶供者(5年dnDSA发生率：18.7%对6.4%，P=0.038；单侧包膜5年发生率：45.6%对19.4%，P=0.011)。然而，在接受配偶和非配偶LDLLT的受者之间，总体存活率或慢性肺移植无功能障碍的存活率没有显著差异(P>；0.99和P=0.434)。结论：尽管配偶和非配偶的LDLLT在预后上没有显著差异，但由于dnDSA和单侧包膜移植的发生率较高，因此应更多地关注配偶LDLLT。
Background.The effect of human leukocyte antigen mismatches between donors and recipients on postoperative outcomes of lung transplantation remains controversial. We retrospectively reviewed adult recipients receiving living-donor lobar lung transplantation (LDLLT) to examine the difference in de novo donor-specific antibody (dnDSA) development and clinically diagnosed unilateral chronic lung allograft dysfunction per graft (unilateral CLAD) between lung grafts donated by spouses (nonblood relatives) and nonspouses (relatives within the third degree). We also investigated the difference in prognoses between recipients undergoing LDLLTs including spouse donors (spousal LDLLTs) and not including spouse donors (nonspousal LDLLTs).Methods.In this study, 63 adult recipients undergoing LDLLTs (61 bilateral and 2 unilateral LDLLTs from 124 living donors) between 2008 and 2020 were enrolled. The cumulative incidence of dnDSAs per lung graft was calculated, and prognoses were compared between recipients undergoing spousal and nonspousal LDLLTs.Results.The cumulative incidence of both dnDSAs and unilateral CLAD in grafts donated by spouses was significantly higher than that in grafts donated by nonspouses (5-y incidence of dnDSAs: 18.7% versus 6.4%, P= 0.038; 5-y incidence of unilateral CLAD: 45.6% versus 19.4%, P= 0.011). However, there were no significant differences in the overall survival or chronic lung allograft dysfunction-free survival between recipients undergoing spousal and nonspousal LDLLTs (P> 0.99 and P= 0.434, respectively).Conclusions.Although there were no significant differences in prognoses between spousal and nonspousal LDLLTs, more attention should be paid to spousal LDLLTs because of the higher development rate of dnDSAs and unilateral CLAD.
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HLA II 类 Eplet 不匹配预测肺移植后 De Novo DSA 的形成。
影响因子：
1.5
作者：
D. Walton;L. Cantwell;S. Hiho;Joseph Ta;S. Wright;L. Sullivan;G. Snell;G. Westall
通讯作者：
G. Westall
影响因子：
2.1
作者：
Islam, Ana K.;Sinha, Neeraj;Gaber, A. Osama
通讯作者：
Gaber, A. Osama
影响因子：
2.3
作者：
Saito, Masao;Chen-Yoshikawa, Toyofumi F.;Date, Hiroshi
通讯作者：
Date, Hiroshi
影响因子：
8.9
作者：
Verleden, Geert M.;Glanville, Allan R.;Vos, Robin
通讯作者：
Vos, Robin
DOI：
10.1016/j.healun.2010.05.006
发表时间：
2010-09
期刊：
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
影响因子：
--
作者：
Hachem RR;Yusen RD;Meyers BF;Aloush AA;Mohanakumar T;Patterson GA;Trulock EP
通讯作者：
Trulock EP