Department of Thoracic Surgery, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
J Heart Lung Transplant. 2012 Apr;31(4):349-53. doi: 10.1016/j.healun.2011.12.007. Epub 2012 Feb 3.
The aim of our study is to review and update the long-term results from our previously published series of lung transplantation in uncontrolled non-heart-beating donors (NHBDs).
A prospective collection of data was undertaken from all lung transplants performed among uncontrolled NHBDs between 2002 and December 2009. The statistical analysis was performed using SPSS software and survival was estimated using the Kaplan-Meier method.
Twenty-nine lung transplants were performed. Mean total ischemic times for the first and second lung were 575 minutes (SD 115.6) and 701 minutes (SD 111.3), respectively. Primary graft dysfunction (PGD) G1, G2 and G3 occurred in 5 cases (17%), 5 cases (17%) and 11 cases (38%), respectively. Overall hospital mortality rate was 17% (5 patients). Statistical analysis revealed a statistically significant association of mortality with ischemic times and with PGD. In terms of overall survival, 3-month, 1-year, 2-year and 5-year survival rates were 78%, 68%, 57% and 51%, respectively, and the conditional survival rates in those who survived the first 3 months were 86%, 72% and 65%, respectively. The cumulative incidence of bronchiolitis obliterans syndrome (BOS) was 11%, 35% and 45% at 1, 3 and 5 years, respectively.
Lung transplantation from uncontrolled non-heart-beating donors shows acceptable results for both mid- and long-term survival and BOS; however, the higher rates of PGD and its impact on early mortality must make us more demanding with respect to the acceptance criteria and methods of evaluation used with these donors.
本研究旨在回顾和更新我们之前发表的非心脏死亡供者（NHBD）肺移植系列研究的长期结果。
前瞻性收集 2002 年至 2009 年 12 月间所有非控制型 NHBD 肺移植患者的数据。使用 SPSS 软件进行统计学分析，采用 Kaplan-Meier 方法估计生存率。
共进行了 29 例肺移植。第一和第二肺的总缺血时间分别为 575 分钟（SD 115.6）和 701 分钟（SD 111.3）。原发性移植物功能障碍（PGD）G1、G2 和 G3 分别发生在 5 例（17%）、5 例（17%）和 11 例（38%）中。总住院死亡率为 17%（5 例）。统计分析显示，死亡率与缺血时间和 PGD 有显著相关性。在总体生存方面，3 个月、1 年、2 年和 5 年生存率分别为 78%、68%、57%和 51%，而在存活 3 个月以上的患者中，其生存率分别为 86%、72%和 65%。1 年、3 年和 5 年时，闭塞性细支气管炎综合征（BOS）的累积发生率分别为 11%、35%和 45%。
来自非心脏死亡供者的肺移植在中、长期生存和 BOS 方面具有可接受的结果；然而，PGD 的较高发生率及其对早期死亡率的影响，使得我们对这些供者的接受标准和评估方法的要求更加严格。
