Right single lung transplantation or double lung transplantation compared with left single lung transplantation in chronic obstructive pulmonary disease.
Right single lung transplantation or double lung transplantation compared with left single lung transplantation in chronic obstructive pulmonary disease.
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与慢性阻塞性肺部疾病中的左单肺移植相比，右单肺移植或双肺移植。
DOI：
10.1016/j.healun.2020.06.009
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发表时间：
2020-09
期刊：
影响因子：
--
通讯作者：
D'Ovidio F
中科院分区：
文献类型：
--
作者：
Benvenuto LJ;Costa J;Piloni D;Aversa M;Anderson MR;Shah L;Robbins HY;Stanifer B;Sonett JR;Arcasoy SM;D'Ovidio F
虽然单肺和双肺移植治疗慢性阻塞性肺疾病（COPD）的结果已经过研究，但右肺和左肺单肺移植从未进行过严格的比较，以评估疾病特异性差异。COPD的单肺移植通常会出现对侧自体肺过度充气，这在左肺移植中可能更明显。我们使用器官共享联合网络登记处，对2005年5月4日至2017年6月30日期间因COPD接受肺移植的5，585名成人进行了回顾性队列研究。受试者随访至2019年3月。采用考克斯比例风险和Royston和Parmar的灵活参数生存模型比较移植后生存率。我们调整了已知或可能与存活率相关的供体和受体因素。与因COPD接受右单肺移植的受者相比，因COPD接受左单肺移植的肺移植受者的移植后死亡风险增加（风险比[HR]：1.24，95% CI：1.08-1.48，p = 0.002）。双肺移植和右单肺移植受者之间的生存率无显著差异（HR：0.88，95% CI：0.77-1.02，p = 0.086）。双肺受体的校正5年生存率为57.8%（95%CI：55.7-60.1），右单肺受体为56.7%（95%CI：55.4-58.0），左单肺受体为50.9%（95%CI：47.2-55.0）。在COPD患者中，与左单肺移植相比，右单肺移植与移植后生存率改善相关，与双肺移植相比，移植后生存率无显著差异，鉴于供体肺持续短缺，应考虑优先将右单肺分配给COPD患者。
Although single and double lung transplantation outcomes for chronic obstructive pulmonary disease (COPD) have been investigated, right and left single lung transplants have never been rigorously compared to evaluate disease-specific differences. Single lung transplants for COPD often have hyperinflation of the contralateral native lung, which may be more pronounced in left lung transplants. Using the United Network for Organ Sharing registry, we conducted a retrospective cohort study of 5,585 adults who underwent lung transplantation for COPD from May 4, 2005 to June 30, 2017. Subjects were followed until March 2019. Post-transplant survival was compared using Cox proportional hazards and Royston and Parmar’s flexible parametric survival models. We adjusted for donor and recipient factors with known or plausible associations with survival. Lung transplant recipients who received a left single lung transplant for COPD had an increased risk of post-transplant death when compared with those who received a right single lung transplant for COPD (hazard ratio [HR]: 1.24, 95% CI: 1.08–1.48, p = 0.002). Survival did not differ significantly between double lung transplant and right single lung transplant recipients (HR: 0.88, 95% CI: 0.77–1.02, p = 0.086). Adjusted 5-year survival was 57.8% (95% CI: 55.7–60.1) for double lung recipients, 56.7% (95% CI: 55.4–58.0) for right single lung recipients, and 50.9% (95% CI: 47.2–55.0) for left single lung recipients. In COPD, right single lung transplantation was associated with improved post-transplant survival compared with left single lung transplantation, and no significant difference in post-transplant survival compared with double lung transplantation was found. In light of the ongoing donor lung shortage, preferential allocation of right single lungs to patients with COPD should be considered.
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影响因子：
7.7
作者：
Textor, Johannes;van der Zander, Benito;Ellison, George T. H.
通讯作者：
Ellison, George T. H.
DOI：
10.1164/rccm.200403-323oc
发表时间：
2004-12-01
影响因子：
24.7
作者：
De Groote, A;Van Muylem, A;Estenne, M
通讯作者：
Estenne, M
影响因子：
8.8
作者：
Benvenuto, Luke J.;Anderson, David R.;Arcasoy, Selim M.
通讯作者：
Arcasoy, Selim M.
影响因子：
6.2
作者：
Smits, JMA;Melman, S;Van Raemdonck, D
通讯作者：
Van Raemdonck, D
影响因子：
3.4
作者：
Tsagkaropoulos, Sokratis;Belmans, Ann;Van Raemdonck, Dirk
通讯作者：
Van Raemdonck, Dirk