One-Year Survival Worse for Lung Retransplants Relative to Primary Lung Transplants.
One-Year Survival Worse for Lung Retransplants Relative to Primary Lung Transplants.
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DOI：
10.1016/j.athoracsur.2021.03.112
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发表时间：
2022-04
期刊：
影响因子：
--
通讯作者：
Puri V
中科院分区：
文献类型：
--
作者：
Randhawa SK;Yang Z;Morkan DB;Yan Y;Chang SH;Hachem RR;Witt CA;Byers DE;Kulkarni HS;Guillamet RV;Kozower BD;Nava RG;Meyers BF;Patterson GA;Kreisel D;Puri V
与初次肺移植（PLT）相比，再次肺移植（LRT）后的结局仍然较差。我们研究了中心容量对LRT后一年生存率的影响。使用UNOS数据库，我们提取了2006年1月至2017年12月期间接受PLT和LRT的患者，不包括心肺联合移植和多次再次移植。使用倾向评分匹配比较PLT和LRT后的一年生存率。在LRT队列中，采用多变量考克斯模型（有或无时间依赖性系数）来检验移植中心容量与1年生存率之间的关系。中心体积分类的基础上检查的限制三次样条。共纳入20，675名接受者（PLT 19853 [96.0%] vs. LRT 822 [4.0%]）。在匹配的队列中，LRT接受者的一年生存率较低（PLT 84.8% vs LRT 76.7%）。LRT后的一年生存率稳步改善（2006-2009年为72.1%，2010-2013年为76.6%，2014-2017年为80.1%）。LRT后较高的中心容量与较好的1年生存率相关。在移植后最初30天观察到这种存活率差异（中等体积与低体积，HR 0.282 [0.151-0.526];高体积与低体积HR 0.406 [0.224-0.737]），但在30天后变得不显著。高容量中心LRT后上级1年生存率主要是由于30天结局较好。这一发现表明，LRT候选人可能会被转介到更高容量的中心进行手术。
Outcomes after lung re-transplantation (LRT) remain inferior compared to primary lung transplantation (PLT). We examined the impact of center volume on one-year survival after LRT. Using the UNOS database, we abstracted patients undergoing PLT and LRT between January 2006 and December 2017, excluding combined heart-lung transplants and multiple re-transplants. One-year survival after PLT and LRT were compared using propensity score matching. In the LRT cohort, multivariable Cox models with and without time-dependent coefficients were fitted to examine association between transplant center volume and 1-year survival. Center volume was categorized based on inspection of restricted cubic splines. A total of 20,675 recipients (PLT 19853 [96.0%] vs. LRT 822 [4.0%]) were included. One-year survival was lower for LRT recipients in the matched cohort (PLT 84.8% vs LRT 76.7%). There was steady improvement in one-year survival after LRT (2006–2009 72.1% vs. 2010–2013 76.6% vs. 2014–2017 80.1%). Higher center volume was associated with better 1-year survival after LRT. This survival difference was noted in the initial 30 days after transplantation (Intermediate vs. Low volume, HR 0.282 [0.151–0.526]; High vs. Low volume HR 0.406 [0.224–0.737]) but became insignificant after 30 days. Superior 1-year survival after LRT at higher volume centers is predominantly due to better 30-day outcomes. This finding suggests that LRT candidates may be referred to higher volume centers for surgery.
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影响因子：
8.9
作者：
Chambers, Daniel C.;Cherikh, Wida S.;Stehlik, Josef
通讯作者：
Stehlik, Josef
外表型对肺部再生后生存的影响：一项多中心研究。
DOI：
10.1111/ajt.13281
发表时间：
2015-08
期刊：
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
影响因子：
--
作者：
Verleden SE;Todd JL;Sato M;Palmer SM;Martinu T;Pavlisko EN;Vos R;Neyrinck A;Van Raemdonck D;Saito T;Oishi H;Keshavjee S;Greer M;Warnecke G;Gottlieb J;Haverich A
通讯作者：
Haverich A
DOI：
10.1016/s0022-5223(95)70063-3
发表时间：
1995-11-01
影响因子：
6
作者：
NOVICK, RJ;SCHAFERS, HJ;PATTERSON, GA
通讯作者：
PATTERSON, GA
影响因子：
4.6
作者：
Roy, Sreeja Biswas;Panchanathan, Roshan;Smith, Michael A.
通讯作者：
Smith, Michael A.
影响因子：
4.6
作者：
Novick, RJ;Stitt, LW;Yacoub, MH
通讯作者：
Yacoub, MH