Barr Mark L, Bourge Robert C, Orens Jonathan B, McCurry Kenneth R, Ring W Steves, Hulbert-Shearon Tempie E, Merion Robert M
University of Southern California, Los Angeles, CA, USA.
Am J Transplant. 2005 Apr;5(4 Pt 2):934-49. doi: 10.1111/j.1600-6135.2005.00836.x.
Using OPTN/SRTR data, this article reviews the state of thoracic organ transplantation in 2003 and the previous decade. Time spent on the heart waiting list has increased significantly over the last decade. The percentage of patients awaiting heart transplantation for >2 years increased from 23% in 1994 to 49% by 2003. However, there has been a general decline in heart waiting list death rates over the decade. In 2003, the lung transplant waiting list reached a record high of 3,836 registrants, up slightly from 2002 and more than threefold since 1994. One-year patient survival for those receiving lungs in 2002 was 82%, a statistically significant improvement from 2001 (78%). The number of patients awaiting a heart-lung transplant, declining since 1998, reached 189 in 2003. Adjusted patient survival for heart-lung recipients is consistently worse than the corresponding rate for isolated lung recipients, primarily due to worse outcomes for heart-lung recipients with congenital heart disease. A new lung allocation system, approved in June 2004, derives from the survival benefit of transplantation with consideration of urgency based on waiting list survival, instead of being based solely on waiting time. A goal of the policy is to minimize deaths on the waiting list.
本文利用器官共享联合网络（OPTN）/器官获取与移植网络（SRTR）的数据，回顾了2003年及此前十年间胸器官移植的状况。在过去十年中，心脏等待名单上的等待时间显著增加。等待心脏移植超过2年的患者比例从1994年的23%增至2003年的49%。然而，在这十年间，心脏等待名单上的死亡率总体呈下降趋势。2003年，肺移植等待名单上的登记人数达到创纪录的3836人，比2002年略有增加，是1994年的三倍多。2002年接受肺移植患者的一年生存率为82%，与2001年（78%）相比有统计学意义上的显著提高。等待心肺移植的患者人数自1998年以来一直在下降，2003年降至189人。心肺移植受者的调整后生存率一直低于单纯肺移植受者的相应生存率，主要原因是患有先天性心脏病的心肺移植受者预后较差。2004年6月批准的新肺分配系统，是基于移植的生存获益，并根据等待名单上的生存情况考虑紧迫性，而非仅仅基于等待时间。该政策的一个目标是尽量减少等待名单上的死亡人数。
