Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Clinics (Sao Paulo). 2009;64(6):519-25. doi: 10.1590/s1807-59322009000600006.
The purpose of this study was to compare spirometry data between patients who underwent single-lung or double-lung transplantation the first year after transplantation.
Lung transplantation, which was initially described as an experimental method in 1963, has become a therapeutic option for patients with advanced pulmonary diseases due to improvements in organ conservation, surgical technique, immunosuppressive therapy and treatment of post-operative infections.
We retrospectively reviewed the records of the 39 patients who received lung transplantation in our institution between August 2003 and August 2006. Twenty-nine patients survived one year post-transplantation, and all of them were followed.
The increase in lung function in the double-lung transplant group was more substantial than that of the single-lung transplant group, exhibiting a statistical difference from the 1st month in both the forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC) in comparison to the pre-transplant values (p <0.05). Comparison between double-lung transplant and single lung-transplant groups of emphysema patients demonstrated a significant difference in lung function beginning in the 3rd month after transplantation.
The analyses of the whole group of transplant recipients and the sub-group of emphysema patients suggest the superiority of bilateral transplant over the unilateral alternative. Although the pre-transplant values of lung function were worse in the double-lung group, this difference was no longer significant in the subsequent months after surgery.
Although both groups demonstrated functional improvement after transplantation, there was a clear tendency to greater improvement in FVC and FEV1 in the bilateral transplant group. Among our subjects, double-lung transplantation improved lung function.
本研究旨在比较单肺移植和双肺移植患者在移植后第一年的肺功能数据。
肺移植最初于 1963 年被描述为一种实验方法,由于器官保存、手术技术、免疫抑制治疗和术后感染治疗的改进,它已成为晚期肺部疾病患者的一种治疗选择。
我们回顾性分析了 2003 年 8 月至 2006 年 8 月期间在我院接受肺移植的 39 例患者的记录。29 例患者在移植后 1 年存活,对所有患者进行了随访。
双肺移植组的肺功能增加更为显著,与单肺移植组相比,在第 1 个月时用力呼气量(FEV1)和用力肺活量(FVC)与移植前相比均有统计学差异(p<0.05)。与单肺移植组相比,肺气肿患者的双肺移植和单肺移植组的肺功能比较在移植后第 3 个月开始出现显著差异。
对所有移植受者的分析和肺气肿患者的亚组分析表明,双侧移植优于单侧移植。尽管双肺移植组的移植前肺功能值较差,但在术后随后的几个月中,这种差异不再显著。
尽管两组患者在移植后均显示出功能改善,但在双肺移植组中 FVC 和 FEV1 的改善更为明显。在我们的研究对象中,双肺移植改善了肺功能。