Short- and long-term outcomes of 1000 adult lung transplant recipients at a single center
Short- and long-term outcomes of 1000 adult lung transplant recipients at a single center
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DOI：
10.1016/j.jtcvs.2010.09.009
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发表时间：
2011-01-01
影响因子：
6
通讯作者：
Patterson, G. Alexander
中科院分区：
文献类型：
--
作者：
Kreisel, Daniel;Krupnick, Alexander S.;Patterson, G. Alexander
目的：肺移植已成为终末期肺部疾病的公认治疗方法。本研究的目的是回顾单一机构的成人肺移植经验。方法：我们回顾了1988年7月至2009年1月在华盛顿大学进行的1000例成人肺移植手术。结果：肺气肿（52%）、囊性纤维化（18.2%）、肺纤维化（16.1%）、肺血管疾病（7.2%）行移植手术。总体接受者年龄为48 +/- 13岁，从43 +/- 12岁（1988年7月- 1993年11月）增加到50 +/- 14岁（2005年6月- 2009年1月）。原发性移植物功能障碍的总发生率为22.1%。有原发性移植物功能障碍的患者住院死亡率更高（原发性移植物功能障碍，13.6%；无原发性移植物功能障碍，4%;P < 0.001）。闭塞性细支气管炎综合征1年时的解脱率为84%，5年时为38.2%，10年时为12.2%。1年、5年、10年和15年生存率分别为84%、56.4%、32.2%和17.8%。5年生存率从49.6%（1988年7月- 1993年11月）提高到62.1%（2001年10月- 2005年6月）。原发性移植物功能障碍与较低的1年、5年和10年生存率相关（原发性移植物功能障碍：分别为72.8%、43.9%和18.7%；无原发性移植物功能障碍：分别为87.1%、59.8%和35.7%）
Objective: Lung transplantation has become accepted therapy for end-stage pulmonary disease. The objective of this study was to review a single-institution experience of adult lung transplants.Methods: We reviewed 1000 adult lung transplants that were performed at Washington University between July 1988 and January 2009.Results: Transplants were performed for emphysema (52%), cystic fibrosis (18.2%), pulmonary fibrosis (16.1%), and pulmonary vascular disease (7.2%). Overall recipient age was 48 +/- 13 years with an increase from 43 +/- 12 years (July 1988-November 1993) to 50 +/- 14 years (June 2005-January 2009). Overall incidence of primary graft dysfunction was 22.1%. Hospital mortality was higher for patients who had primary graft dysfunction (primary graft dysfunction, 13.6%; no primary graft dysfunction, 4%; P < .001). Freedom from bronchiolitis obliterans syndrome was 84% at 1 year, 38.2% at 5 years, and 12.2% at 10 years. Survival at 1, 5, 10, and 15 years was 84%, 56.4%, 32.2%, and 17.8%, respectively. Five-year survival improved from 49.6%(July 1988-November 1993) to 62.1%(October 2001-June 2005). Primary graft dysfunction was associated with lower survival at 1, 5, and 10 years (primary graft dysfunction: 72.8%, 43.9%, and 18.7%, respectively; no primary graft dysfunction: 87.1%, 59.8%, and 35.7%, respectively, P