A Decade of Living Lobar Lung Transplantation: Perioperative Complications after 253 Donor Lobectomies †
A Decade of Living Lobar Lung Transplantation: Perioperative Complications after 253 Donor Lobectomies †
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活体肺叶肺移植十年：253 例供体肺叶切除术后的围手术期并发症 †
DOI：
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发表时间：
2004
影响因子：
8.8
通讯作者：
V. Starnes
中科院分区：
文献类型：
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作者：
M. Bowdish;M. Barr;F. A. Schenkel;M. Woo;R. Bremner;M. Horn;C. Baker;R. Barbers;W. Wells;V. Starnes
活体肺叶移植使每个受体面临两个供体的风险。我们检查了在活体肺叶移植的第一个十年期间在我们机构进行的253例供体肺叶切除术的围手术期结果。无围手术期或长期死亡。80.2%的供体（n = 203）无围手术期并发症，而50例（19.8%）有一种或多种并发症。术中并发症发生率为3.6%。需要再次手术的并发症发生在3.2%的供体中。15.0%的供体有其他围手术期并发症;最严重的是2名供体发生肺动脉血栓形成，而最常见的是需要额外的胸廓造口管或胸廓造口管≥14 d，用于持续漏气和/或引流。右侧供体比左侧供体更可能发生围手术期并发症（比值比2.02，p = 0.04），可能继发于右下叶和中叶解剖结构。这一经验表明，供体肺叶切除术的发病率相对较低，没有死亡率，如果考虑到器官持续短缺以及对活体肝移植的哲学和伦理接受程度的差异，在更多的肺移植中心将此手术视为一种选择，这一点很重要。
Living lobar lung transplantation places two donors at risk for each recipient. We examined the perioperative outcomes associated with the 253 donor lobectomies performed at our institution during our first decade of living lobar lung transplantation. There have been no perioperative or long‐term deaths. 80.2% of donors (n = 203) had no perioperative complications, while fifty (19.8%) had one or more complication. The incidence of intraoperative complications was 3.6%. Complications requiring reoperation occurred in 3.2% of donors. 15.0% of donors had other perioperative complications; the most serious were two donors who developed pulmonary artery thrombosis, while the most common was the need for an additional thoracostomy tube or a thoracostomy tube for ≥14 d for persistent air leaks and/or drainage. Right‐sided donors were more likely to have a perioperative complication than left‐sided donors (odd ratio 2.02, p = 0.04), probably secondary to right lower and middle lobe anatomy. This experience has shown donor lobectomy to be associated with a relatively low morbidity and no mortality, and is important if this procedure is to be considered an option at more pulmonary transplant centers, given continued organ shortages and differences in philosophical and ethical acceptance of live