Contat C, Vicente R, Ramos F, Moreno I, Barberá M
Departamento de Anestesiología y Reanimación, Hospital Universitario La Fe, Valencia.
Rev Esp Anestesiol Reanim. 2009 Dec;56(10):635-40. doi: 10.1016/s0034-9356(09)70481-5.
Lung transplantation is an appropriate therapeutic option for patients with advanced sarcoidosis that has not responded to medical treatment. The causes of sarcoidosis are unknown and the course of disease and prognosis are highly variable. As it is difficult to determine the ideal timing for a transplant or the type of transplant to perform, this may influence the high perioperative mortality in these patients. Postoperative morbidity and mortality rates are high when pulmonary hypertension is present before the transplant or when primary graft failure, acute rejection, infection, or other complications develop afterwards. We describe 2 patients with a diagnosis of end-stage sarcoidosis who received a lung transplant and a heart-lung transplant. The outcomes were different in each case. We analyze factors related to morbidity and mortality that determined the outcomes.
肺移植是对药物治疗无反应的晚期结节病患者的一种合适治疗选择。结节病的病因尚不清楚,疾病进程和预后差异很大。由于难以确定移植的理想时机或进行何种类型的移植,这可能影响这些患者较高的围手术期死亡率。当移植前存在肺动脉高压或移植后发生原发性移植物功能衰竭、急性排斥反应、感染或其他并发症时,术后发病率和死亡率较高。我们描述了2例诊断为终末期结节病的患者,他们分别接受了肺移植和心肺移植。每种情况的结果都不同。我们分析了决定结果的与发病率和死亡率相关的因素。