Results of clinical lung transplant from uncontrolled non-heart-beating donors
Results of clinical lung transplant from uncontrolled non-heart-beating donors
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DOI：
10.1016/j.healun.2007.01.028
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发表时间：
2007-05-01
影响因子：
8.9
通讯作者：
Varela, Andres
中科院分区：
文献类型：
--
作者：
de Antonio, David Gomez;Marcos, Roberto;Varela, Andres
背景资料：肺移植的移植物稀缺和越来越多的候选人期待器官，导致等待肺移植的患者死亡人数增加。无心跳供体（NHBD）是临床肺移植的一个很有前途的供体来源。我们报告了自2002年以来17例院外NHBD肺移植的结果。研究方法：我们收集了自2002年以来参与NHBD肺移植的17名供体和受体的数据，以及涉及手术类型和围手术期事件的数据。我们描述了术后并发症的发生率，特别关注原发性移植物功能障碍（PGD）、支气管愈合、闭塞性细支气管炎综合征（BOS）和生存率。采用Kaplan-Meier法计算生存曲线。结果如下：9例患者（53%6）报告了G2-G3 PGD，G2在170小时内和G3在168小时内完全恢复动脉氧分压/吸入氧分数比值。没有与PGD直接相关的死亡。7例患者（41%）发生急性排斥反应，其中4例超过1级。移植后第1年BOS发生率为1/14（7%），第2年为2/9（11%），第3年为2/4（509，6）。住院死亡率为17%。3个月生存率为82%，1年生存率为69%，3年生存率为58%。结论：中期结果证实了不加控制的NHBD作为临床移植肺供体的一个有前途的补充来源的充分性。心肺移植杂志2007;26：529-34.版权所有（C）2007国际心肺移植学会。
Background: The scarcity of grafts for lung transplant and the growing number of candidates expecting an organ has led to an increase of deaths in patients waiting for lung transplantation. Non-heart-beating donors (NHBD) represent a promising source of grafts for those who are involved in clinical lung transplantation. We present the results of our series of 17 out-of-hospital NHBD lung transplantations performed since 2002. Methods: We have collected data from 17 donors and recipients involved in NHBD lung transplants since 2002, as well as data referring to the type of procedure and peri-operative events. We describe the incidence of post-operative complications with special attention to primary graft disfunction (PGD), bronchial healing, bronchiolitis obliterans syndrome (BOS), and survival. We used Kaplan-Meier method to obtain the survival curve. Results: G2-G3 PGD was reported in 9 patients (53%6), with a complete restoration of the partial pressure of arterial oxygen/fraction of inspired oxygen ratio in 170 hours for G2 and 168 hours for G3. There were no deaths directly related to PGD. Acute rejection was detected in 7 patients (41%), 4 of which exceeded grade 1. The incidence of BOS after transplantation was 1 (7%) of 14 patients during the first year, 2 (11%) of 9 in the second year, and 2 (509,6) of 4 in the third year. Hospital mortality rate was 17%. The survival rates were 82% at 3 months, 69%, at 1 year, and 58% at 3 years. Conclusions: mid-term results confirm the adequacy of uncontrolled NHBD as a promising complementary source of lung donors for clinical transplant. J Heart Lung Transplant 2007;26:529-34. Copyright (C) 2007 by the International Society for Heart and Lung Transplantation.