Physical function after lung transplantation for late-onset noninfectious pulmonary complications after allogeneic hematopoietic stem cell transplantation
Physical function after lung transplantation for late-onset noninfectious pulmonary complications after allogeneic hematopoietic stem cell transplantation
复制标题
异基因造血干细胞移植后迟发性非感染性肺部并发症肺移植后的身体功能
作者：
Ryota Hamada;Y. Oshima;Susumu Sato;Yuji Yoshioka;Tatsuya Sato;Manabu Nankaku;T. Kondo;T. Chen;R. Ikeguchi;D. Nakajima;H. Date;S. Matsuda
异基因造血干细胞移植（allo-HSCT）后的迟发性非感染性肺部并发症（LONIPCs）是致命的，肺移植是唯一的治愈性治疗方法。虽然LONIPCs的肺移植可能会带来良好的生存率，但目前尚不清楚受损的身体功能是否或如何恢复。因此，本研究旨在研究allo-HSCT后LONIPCs患者肺移植后的长期病程和相关的身体功能变化。这项前瞻性队列研究入组了15名在2012年至2018年期间接受allo-HSCT后LONIPC肺移植的患者。在肺移植前和移植后2年内评估呼吸困难评分、体力状态、身体功能和运动耐量。肺移植后2年，呼吸困难评分和体力状态有所改善，但未完全恢复。使用膝关节伸肌力量（KES）和6分钟步行试验（6 MWT）评估身体功能;结果在移植后3个月之前较差，但在2年内有所改善。6 MWT距离显示改善至接近健康水平（562.7 m）。肺移植术后3个月至2年，运动耐量的恢复与%肺活量（%VC; r=0.5）和KES（r=0.4）的恢复相关。此外，扁平的胸部，这是一个特点的LONIPC患者，影响%VC在移植后2年（r=0.8）。LONIPCs的肺移植可以恢复受损的身体功能。应考虑多方面的康复计划，特别是改善肌无力和肺功能。
Late-onset noninfectious pulmonary complications (LONIPCs) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) are fatal, and lung transplantation is the only curative treatment. Although lung transplantation for LONIPCs may confer good survival rates, it is unclear whether or how impaired physical functioning is restored. Thus, this study aimed to investigate the long-term course and associated changes in physical functions after lung transplantation in patients with LONIPCs after allo-HSCT. This prospective cohort study enrolled 15 patients who received lung transplantation for LONIPCs after allo-HSCT between 2012 and 2018. Dyspnea scores, performance status, physical function, and exercise tolerance were assessed before lung transplantation and up to 2 years after transplantation. Two years after lung transplantation, the dyspnea scores and performance status improved, but did not recover completely. Physical function was assessed using the knee extensor strength (KES) and 6-min walk test (6MWT); the results were poor until 3 months after transplantation but improved over 2 years. The 6MWT distance showed improvement to a nearly healthy level (562.7 m). Recovery of exercise tolerance was associated with recovery in % vital capacity (%VC; r=0.5) and KES (r=0.4) from 3 months to 2 years after lung transplantation. Furthermore, a flat thorax, which is a characteristic of patients with LONIPCs, affected the %VC at 2 years after transplantation (r=0.8). Lung transplantation for LONIPCs may restore impaired physical function. A multifaceted rehabilitation program should be considered, especially to improve muscle weakness and pulmonary function.
影响因子：
4.3
作者：
Chien, Jason W.;Duncan, Steven;Williams, Kirsten M.;Pavletic, Steven Z.
通讯作者：
Pavletic, Steven Z.
造血干细胞移植前患者呼吸和骨骼肌力量受损。
影响因子：
9.6
作者：
White,AlexanderC;Terrin,Norma;Miller,KennethB;Ryan,HelenF
通讯作者：
Ryan,HelenF