Favorable survival in lung transplant recipients on preoperative low-dose, as compared to high-dose corticosteroids, after hematopoietic stem cell transplantation
Favorable survival in lung transplant recipients on preoperative low-dose, as compared to high-dose corticosteroids, after hematopoietic stem cell transplantation
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DOI：
10.1007/s12185-018-2417-3
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发表时间：
2018-06-01
影响因子：
2.1
通讯作者：
Oto, Takahiro
中科院分区：
文献类型：
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作者：
Sugimoto, Seiichiro;Miyoshi, Kentaroh;Oto, Takahiro
尽管造血干细胞移植（HSCT）后发生肺部并发症需要肺移植（LT）的患者数量正在增加，但对这些患者进行肺移植后影响预后的因素知之甚少。皮质类固醇是HSCT后肺部并发症的一线治疗方法；然而，在肝移植前延长皮质类固醇治疗会增加肝移植的潜在风险。在本研究中，我们评估了术前皮质类固醇治疗对HSCT后肝移植患者长期生存的影响。我们回顾性调查了13例接受高剂量皮质类固醇治疗的患者和9例接受低剂量皮质类固醇治疗的HSCT后肺部并发症患者的数据。除了术前皮质类固醇剂量外，患者的临床特征没有差异。低剂量皮质类固醇组术后1年内并发症发生率明显低于对照组（p = 0.026）。低剂量皮质类固醇组LT后生存率也显著优于高剂量皮质类固醇组（p = 0.034）。在HSCT后接受肝移植的患者中，与术前使用高剂量皮质类固醇相比，术前使用低剂量皮质类固醇可以限制肝移植后一年内发生术后并发症的风险，从而提高肝移植后的长期生存率。
Although the number of patients developing pulmonary complications after hematopoietic stem cell transplantation (HSCT) necessitating lung transplantation (LT) is increasing, a little information is available about factors influencing the prognosis after LT in these patients. Corticosteroids represent the first-line therapy for pulmonary complications after HSCT; however, prolonged corticosteroid treatment prior to LT increases the potential risks of LT. In this study, we assessed the effect of preoperative corticosteroid therapy on long-term survival in patients undergoing LT after HSCT. We retrospectively investigated data from 13 patients who had received high-dose corticosteroid therapy and nine who had received low-dose corticosteroid therapy prior to LT for pulmonary complications after HSCT. Other than the preoperative corticosteroid dose, patient clinical characteristics did not differ. The incidence of postoperative complications within the first year after LT was significantly lower in the low-dose corticosteroid group (p = 0.026). Survival after LT was also significantly better in the low-dose corticosteroid group than in the high-dose corticosteroid group (p = 0.034). In recipients of LT after HSCT, preoperative low-dose corticosteroid use, as compared to preoperative high-dose corticosteroid use, could limit the risks of postoperative complications developing within the first year after the LT, leading to improved long-term survival after LT.