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心脏死亡后捐献肺移植的结局。

Donation after cardiac death lung transplantation outcomes.

机构信息

Department of Cardiothoracic Surgery, Loyola University, Chicago, Illinois, USA.

出版信息

Curr Opin Organ Transplant. 2011 Oct;16(5):462-8. doi: 10.1097/MOT.0b013e32834a99ac.

Abstract

PURPOSE OF REVIEW

Lung transplantation is now a well established treatment option for several end-stage respiratory diseases. Survival after lung transplantation has significantly improved over the last decade. The primary limitation to increased utilization of lung transplantation remains donor scarcity. Suitable allografts have been procured from donors after determination of neurologic death and from donors after determination of cardiac death (DDCD or DCD). Historically, the first human lung transplantation performed, utilized an allograft procured after cardiovascular death, also referred to as nonheart-beating donor.The experience at University of Wisconsin in 1993 reintroduced DCD lung transplantation with the first successful clinical case.

RECENT FINDINGS

A potential additional lung allograft source, DCD lung transplantation has been established with very acceptable outcomes observed by several centers. We provide the relevant background for the rationale of donor allograft expansion to include DCD lungs from controlled (Maastricht category III donors).

SUMMARY

This review considers the available evidence for DCD lung transplantation and compares reported primary graft dysfunction rates and current survival data available.

摘要

目的综述

肺移植现已成为多种终末期呼吸系统疾病的有效治疗手段。在过去十年中,肺移植患者的存活率显著提高。限制肺移植广泛应用的主要因素仍然是供体稀缺。合适的同种异体肺已从脑死亡供体和心脏死亡供体(DDCD 或 DCD)中获得。历史上首例进行的人类肺移植使用的是心血管死亡后获取的同种异体肺,也称为无心跳供体。威斯康星大学于 1993 年再次开展 DCD 肺移植,首例临床成功案例由此诞生。

最新发现

潜在的额外肺供体来源是 DCD 肺移植,目前已有多个中心的观察结果证实了其可行性和可接受性。我们提供了供体肺移植扩展的相关背景知识,包括来自控制性(马斯特里赫特分类 III 供体)的 DCD 肺。

总结

本综述考虑了 DCD 肺移植的现有证据,并比较了报告的原发性移植物功能障碍发生率和当前的存活率数据。

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