Orens J B, Shearon T H, Freudenberger R S, Conte J V, Bhorade S M, Ardehali A
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Am J Transplant. 2006;6(5 Pt 2):1188-97. doi: 10.1111/j.1600-6143.2006.01274.x.
This article reviews trends in thoracic organ transplantation based on OPTN/SRTR data from 1995 to 2004. The number of active waiting list patients for heart transplants continues to decline, primarily because there are fewer patients with coronary artery disease listed for transplantation. Waiting times for heart transplantation have decreased, and waiting list deaths also have declined, from 259 per 1000 patient-years at risk in 1995 to 156 in 2004. Fewer heart transplants were performed in 2004 than in 1995, but adjusted patient survival increased to 88% at 1 year and 73% at 5 years. Emphysema, idiopathic pulmonary fibrosis and cystic fibrosis were the most common indications among lung transplant recipients in 2004. Waiting time for lung transplantation decreased between 1999 and 2004. Waiting list mortality decreased to 134 per 1000 patient-years at risk in 2004. One-year survival following transplantation has improved significantly in the past decade. The number of combined heart-lung transplants performed in the United States remains low, with only 39 performed in 2004. Overall unadjusted survival, at 58% at 1 year and 40% at 5 years, is lower among heart-lung recipients than among either heart or lung recipients alone.
本文基于1995年至2004年器官共享联合网络（OPTN）/器官获取与移植网络（SRTR）的数据，回顾了胸外科器官移植的趋势。心脏移植活跃等待名单上的患者数量持续下降，主要原因是列入移植名单的冠心病患者减少。心脏移植的等待时间缩短，等待名单上的死亡人数也有所下降，从1995年每1000患者年风险中的259例降至2004年的156例。2004年进行的心脏移植手术比1995年减少，但调整后的患者生存率在1年时提高到88%，5年时提高到73%。2004年，肺气肿、特发性肺纤维化和囊性纤维化是肺移植受者中最常见的适应症。1999年至2004年期间，肺移植的等待时间缩短。2004年，等待名单上的死亡率降至每1000患者年风险中的134例。在过去十年中，移植后的1年生存率有了显著提高。美国进行的心肺联合移植数量仍然很少，2004年仅进行了39例。心肺联合移植受者的总体未调整生存率在1年时为58%，5年时为40%，低于单独进行心脏或肺移植的受者。
