Shennib H, Noirclerc M, Ernst P, Metras D, Mulder D S, Giudicelli R, Lebel F, Dumon J F
Thoracic Surgery Departments, Ste-Marguerite Hospital, Marseille, France.
Ann Thorac Surg. 1992 Jul;54(1):27-31; discussion 31-2. doi: 10.1016/0003-4975(92)91135-v.
One hundred twenty cystic fibrosis patients were accepted for transplantation. Twenty-five patients underwent double-lung transplantation. Twenty-five patients died awaiting transplantation (20.6%). There were 13 female and 12 male patients. Their mean age was 28 years (range, 7 to 34 years), and mean percentage ideal body weight was 76% (range, 58.5% to 91.9%). Most patients were hypoxic and hypercarbic. Two patients underwent tracheal anastomosis, 15 had en bloc bronchial anastomoses, and 8 had sequential single-lung transplants. Operative mortality was 16%; all deaths were related to bleeding from extensive adhesions. Actuarial survival at 1 year was 64%. Rejection and infection were frequent during the first month and decreased thereafter. Airway complications occurred in 5 patients but were amenable to laser therapy and stenting. We conclude that double-lung transplantation is an acceptable modality for the treatment of cystic fibrosis patients with end-stage lung disease. It may be a better alternative to heart-lung transplantation considering the paucity of thoracic organ donors.
120例囊性纤维化患者接受了移植手术。25例患者接受了双肺移植。25例患者在等待移植期间死亡（20.6%）。患者中有13名女性和12名男性。他们的平均年龄为28岁（范围为7至34岁），平均理想体重百分比为76%（范围为58.5%至91.9%）。大多数患者存在低氧血症和高碳酸血症。2例患者进行了气管吻合术，15例进行了整块支气管吻合术，8例进行了序贯单肺移植。手术死亡率为16%；所有死亡均与广泛粘连导致的出血有关。1年的精算生存率为64%。排斥反应和感染在第一个月较为频繁，之后有所减少。5例患者出现气道并发症，但可通过激光治疗和支架置入术进行处理。我们得出结论，双肺移植是治疗终末期肺病囊性纤维化患者的一种可接受的方式。考虑到胸器官供体的稀缺，它可能是心肺移植的更好替代方案。
