Ischemia-reperfusion injury after lung transplantation increases risk of late bronchiolitis obliterans syndrome
Ischemia-reperfusion injury after lung transplantation increases risk of late bronchiolitis obliterans syndrome
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DOI：
10.1016/s0003-4975(01)03606-2
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发表时间：
2002-04-01
影响因子：
4.6
通讯作者：
Kron, IL
中科院分区：
文献类型：
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作者：
Fiser, SM;Tribble, CG;Kron, IL
背景闭塞性细支气管炎综合征（BOS）是肺移植术后长期发病和死亡的最常见原因。我们的假设是肺移植后早期缺血再灌注损伤增加了BOS的风险。对1990年1月1日至2000年1月1日期间134例肺移植患者的资料进行单因素和多因素Logistic回归分析。肺移植后115例（115/134，86%）存活3个月以上。在该组中，41例患者发生BOS，其中23例疾病进展。单变量分析显示缺血再灌注损伤（p = 0.017）和两次或多次急性排斥反应（p = 0.032）是BOS发生的预测因子，而缺血再灌注损伤（p = 0.011）和巨细胞病毒感染（p = 0.009）预测进行性BOS。多因素Logistic回归分析显示，缺血再灌注损伤是BOS发生和进展的独立预测因子。两次或两次以上的急性排斥反应也是BOS发生的独立预测因子，而巨细胞病毒感染是进展性BOS的独立预测因子。缺血再灌注损伤增加了肺移植后BOS的风险。(C)2002年由胸外科医师协会出版。
Background. Bronchiolitis obliterans syndrome (BOS) is the most common cause of long-term morbidity and mortality after lung transplantation. Our hypothesis was that early ischemia-reperfusion injury after lung transplantation increases the risk of BOS.Methods. Data on 134 patients who had lung transplantation between January 1, 1990 and January 1, 2000, was used for univariate and multivariate logistic regression analysis.Results. After lung transplantation, 115 patients (115 of 134, 86%) survived more than 3 months. In that group, 41 patients developed BOS, of which 23 had progressive disease. Univariate analysis revealed that ischemia-reperfusion injury (p = 0.017) and two or more acute rejection episodes (p = 0.032) were predictors of BOS onset, whereas ischemia-reperfusion injury (p = 0.011) and cytomegalovirus infection (p = 0.009), predicted progressive BOS. Multivariate logistic regression analysis showed that ischemia-reperfusion injury was an independent predictor for both BOS development and BOS progression. Two or more acute rejection episodes were also an independent predictor of BOS development, whereas cytomegalovirus infection was an independent predictor of progressive BOS.Conclusions. Ischemia-reperfusion injury increases the risk of BOS after lung transplantation. (C) 2002 by The Society of Thoracic Surgeons.