Dezza M C, Parigi P C, Corno V, Lucianetti A, Pinelli D, Zambelli M, Guizzetti M, Aluffi A, Tagliabue F, Platto M, Codazzi D, Triggiani M, Colledan M
Chirurgia III, Centro Trapianto di Fegato e di Polmone, Ospedali Riuniti di Bergamo, Italy.
Transplant Proc. 2010 May;42(4):1262-4. doi: 10.1016/j.transproceed.2010.03.093.
Use of extended criteria donors is one of the strategies to face the scarcity of donors for lung transplantation.
Between November 2002 and May 2009, we performed 52 LTs in 50 recipients, 10 of whom (group A) received lungs from donors aged 55 years or older (median, 58.5; range, 56-66 years) for comparison with 28 patients (group B) transplanted with lungs from donors younger than 55 years (median, 25.5; range, 15-54 years). We excluded 9 children and 3 recipients of combined liver plus lung transplantations from the study.
Recipient age, gender, and indications for transplantation did not differ significantly between the 2 groups. Neither were there significant differences in PaO2/FiO2 ratios before lung retrieval, or length of the ischemic time The first PaO2/FiO2 on arrival to the intensive care unit (ICU) and the median length of ICU stay were similar. All patients, except 2 who died in the operating theatre, were extubated between 3 and 216 hours after the transplantation. Hospital mortality was similar in both groups: 3 patients in group A and 2 in group B (P = .1). The median portions of the predicted 1-second forced expiratory volume (FEV1) at 6 months after transplantation did not differ in the 2 groups: 62.4% in group A versus 70% in group B (P = .85).
Lung grafts from donors older than 55 years can be effectively used for transplantation, thus increasing the total organ pool.
使用扩大标准供体是应对肺移植供体短缺的策略之一。
2002年11月至2009年5月期间,我们对50名受者进行了52例肺移植手术,其中10名受者(A组)接受了年龄在55岁及以上供体的肺(中位数为58.5岁;范围为56 - 66岁),与28例接受年龄小于55岁供体肺移植的患者(B组)(中位数为25.5岁;范围为15 - 54岁)进行比较。我们将9名儿童和3例肝肺联合移植受者排除在研究之外。
两组受者的年龄、性别和移植指征无显著差异。肺获取前的PaO2/FiO2比值或缺血时间长度也无显著差异。入住重症监护病房(ICU)时的首次PaO2/FiO2以及ICU住院时间中位数相似。除2例在手术室死亡的患者外,所有患者在移植后3至216小时内拔管。两组的医院死亡率相似:A组3例,B组2例(P = 0.1)。移植后6个月时,两组预测的1秒用力呼气量(FEV1)中位数无差异:A组为62.4%,B组为70%(P = 0.85)。
55岁以上供体的肺移植物可有效用于移植,从而增加了总的器官库。