Bjørtuft Øystein, Geiran Odd
Lungemedisinsk avdeling, Rikshospitalet, Oslo.
Tidsskr Nor Laegeforen. 2003 Nov 20;123(22):3206-9.
Lung transplantation has been a therapeutic option for end-stage pulmonary disease in Norway since 1990 and there has been an increasing shortage of donor lungs.
The present study evaluates the assessment of a total of 409 patients (212 men and 197 women) referred in the period between 1990 and 2001.
The most frequent diagnoses were chronic obstructive pulmonary disease (45%), a1-antitrypsin deficiency with emphysema (15%), idiopathic pulmonary fibrosis (14%), cystic fibrosis (7%) and sarcoidosis (6%). Among patients with chronic obstructive pulmonary disease, 53% were female. Numbers of referred and transplanted patients per 100 000 inhabitants did not differ significantly between the five health regions of Norway. The number of transplantations has been stable, 10-15 per year, while the number of patients on the waiting list has gradually increased to 30-40. Mean waiting time has increased to 500-600 days. Total mortality rate during assessment and on the waiting list was 41%. Patients with idiopathic pulmonary fibrosis and cystic fibrosis had significantly higher mortality than patients with chronic obstructive pulmonary disease and a1-antitrypsin deficiency with emphysema (63%, 72%, 26%, 21% respectively). Patients with idiopathic pulmonary fibrosis died after a median of 188 days on the waiting list, while patients with cystic fibrosis died after a median of 729 days.
Patients with idiopathic pulmonary fibrosis should be referred earlier and patients with idiopathic pulmonary fibrosis and cystic fibrosis should be given higher priority on the waiting list.
自1990年以来，肺移植一直是挪威终末期肺病的一种治疗选择，供肺短缺问题日益严重。
本研究评估了1990年至2001年期间转诊的总共409例患者（212名男性和197名女性）。
最常见的诊断为慢性阻塞性肺疾病（45%）、α1抗胰蛋白酶缺乏症合并肺气肿（15%）、特发性肺纤维化（14%）、囊性纤维化（7%）和结节病（6%）。在慢性阻塞性肺疾病患者中，53%为女性。挪威五个健康区域每10万居民中转诊和移植患者的数量没有显著差异。移植数量一直稳定，每年10 - 15例，而等待名单上的患者数量已逐渐增加到30 - 40例。平均等待时间增加到500 - 600天。评估期间和等待名单上的总死亡率为41%。特发性肺纤维化和囊性纤维化患者的死亡率显著高于慢性阻塞性肺疾病和α1抗胰蛋白酶缺乏症合并肺气肿患者（分别为63%、72%、26%、21%）。特发性肺纤维化患者在等待名单上中位188天后死亡，而囊性纤维化患者在等待名单上中位729天后死亡。
特发性肺纤维化患者应更早转诊，特发性肺纤维化和囊性纤维化患者在等待名单上应被给予更高优先级。
