Quétant S, Rochat T, Pison C
Groupe de transplantation pulmonaire de Grenoble, pôle de médecine aiguë et communautaire, clinique de pneumologie, fédération Grenoble transplantation, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France.
Rev Mal Respir. 2010 Oct;27(8):921-38. doi: 10.1016/j.rmr.2010.08.001. Epub 2010 Sep 29.
Lung transplantation has experienced an increasing expansion with a significant improvement in results with the passage of time. Evaluation of these results consists of several domains: survival, function, quality of life and cost-effectiveness.
The success of lung transplantation is confirmed by a median survival that currently exceeds 5 years. Cystic fibrosis is the disease associated with the best results with, in France, a survival of 76% at 1 year, 56% at 5 years and 47% at 10 years and a median survival of 8 years. According to French data the 5-year survival is 46% for PAHT, 42% for COPD and 36% for pulmonary fibrosis. Studies have shown a survival benefit for cystic fibrosis and interstitial lung disease but definitive conclusions cannot be drawn for patients with COPD. Lung transplantation brings similar benefits in terms of quality of life and cost-effectiveness.
New statistical methods would allow a better estimate in terms of years of survival and quality of life to be made for each candidate on an individual basis.
Lung transplantation improves survival and quality of life compared to medical treatment, at an acceptable cost. These outcomes should be assessed at both an individual and social level to justify the resources involved.
随着时间的推移，肺移植取得了显著进展，其应用范围不断扩大，效果也有了显著改善。对这些结果的评估包括几个方面：生存率、功能、生活质量和成本效益。
肺移植的成功已通过目前超过5年的中位生存期得到证实。囊性纤维化是与最佳结果相关的疾病，在法国，1年生存率为76%，5年生存率为56%，10年生存率为47%，中位生存期为8年。根据法国的数据，肺动脉高压患者的5年生存率为46%，慢性阻塞性肺疾病（COPD）患者为42%，肺纤维化患者为36%。研究表明，囊性纤维化和间质性肺病患者在生存方面有获益，但对于COPD患者，尚无定论。肺移植在生活质量和成本效益方面也带来了类似的益处。
新的统计方法将有助于在个体层面上对每个候选者的生存年限和生活质量进行更好的评估。
与药物治疗相比，肺移植在可接受的成本下提高了生存率和生活质量。这些结果应在个体和社会层面进行评估，以证明所涉及资源的合理性。
