Living-donor lobar lung transplantation for various lung diseases
Living-donor lobar lung transplantation for various lung diseases
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DOI：
10.1016/s0022-5223(03)00235-6
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发表时间：
2003-08-01
影响因子：
6
通讯作者：
Shimizu, N
中科院分区：
文献类型：
--
作者：
Date, H;Aoe, M;Shimizu, N
目的：报告活体大叶肺移植治疗各种肺部疾病的早期经验。方法：1998年10月至2002年3月，对14例终末期肺部疾病患者施行活体大叶肺移植。女性患者3例，男性患者3例，年龄8~53岁，其中儿童4例，成人10例。诊断包括原发性肺动脉高压6例，特发性间质性肺炎2例，闭塞性细支气管炎2例，支气管扩张2例，淋巴管肌瘤病1例，囊性纤维化1例。13例患者行双侧活体大叶肺移植，1例10岁男童合并原发性肺高压患者行右侧单侧活体大叶肺移植。结果：14例患者均存活，随访4~45个月。虽然他们出院时的用力肺活量(1327+/-78毫升，50.2%)是有限的，但室内空气中的动脉血氧分压(98.5+/-1.8分钟汞)和肺动脉收缩压(24.8+/-1.6毫米汞柱)是很好的。迫不得已。肺活量逐渐改善，第一年达1894+/-99毫升，为预计的67.4%。结论：活体大叶肺移植可应用于限制性、梗阻性、败血症和高血压性肺部疾病。对于儿童和成人患者来说，这种类型的手术可以替代传统的身体肺移植，否则他们很快就会死亡。
Objective: We report on our early experience in living-donor lobar lung transplantation for patients with various lung diseases including restrictive, obstructive, septic, and hypertensive lung diseases.Methods: From October 1998 to March 2002, living-donor lobar lung transplantation was performed in 14 patients with end-stage lung diseases. There were I I female patients and 3 male patients, with ages ranging from 8 to 53 years, including 4 children and 10 adults. Diagnoses included primary pulmonary hypertension (n = 6), idiopathic interstitial pneumonia (n = 2), bronchiolitis obliterans (n = 2), bronchiectasis (n = 2), lymphangioleiomyomatosis (n = 1), and cystic fibrosis (n = 1). Bilateral living-donor lobar lung transplantation was performed in 13 patients and right single living-donor lobar lung transplantation was performed for a 10-year-old boy with primary pulmonary hypertension.Results: All the 14 patients are currently alive with a follow-up period of 4 to 45 months. Although their forced vital capacity (1327 +/- 78 mL, 50.2% of predicted) was limited at discharge, arterial oxygen tension on room air (98.5 +/- 1.8 min Hg) and systolic pulmonary artery pressure (24.8 +/- 1.6 mm Hg) were excellent. Forced. vital capacity improved gradually and reached 1894 +/- 99 mL, 67.4% of predicted, at I year. All donors have returned to their previous lifestyles.Conclusions: Living-donor lobar lung transplantation can be applied to restrictive, obstructive, septic, and hypertensive lung diseases. This type of procedure can be an alternative to conventional cadaveric lung transplantation for both pediatric and adult patients who would die soon otherwise.