Paik H C, Haam S J, Lee D Y, Yi G J, Song S W, Kim Y T, Kang C H, Kim K M, Park S I, Jheon S H
Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Seoul, Korea.
Transplant Proc. 2012 May;44(4):865-9. doi: 10.1016/j.transproceed.2011.12.059.
Lung transplantation for end-stage lung disease results in prolonged actuarial survival and improved pulmonary function. However, the shortage of donor lungs has been a major limiting factor in transplantation. The purpose of this study was to analyze the waiting time and mortality rate for each disease entity. The medical records of all patients listed in The Korean Network for Organ Sharing (KONOS) from May 1996 to May 2011 were analyzed to identify waiting times and causes of death. During the study period, 146 patients (86 males and 60 females) of mean age of 46.6 years (range; 5 to 73 years) showed idiopathic pulmonary fibrosis (IPF; n = 61), chronic obstructive pulmonary disease (COPD; n = 19) or bronchiectasis (n = 15). Sixty-five patients (44.5%) underwent lung or heart-lung transplantation. Sixty-two patients (42.5%) expired during the waiting period, and 19 patients are still on the waiting list. The mortality rate while waiting was highest among patients with primary pulmonary hypertension (62.5%) followed by IPF (57.4%), and acute respiratory distress syndrome (ARDS) (55.6%). The mean time from diagnosis to registration in KONOS was 15.5 months among the expired and 13.2 months in the transplanted group (P = .455). The mean time on waiting list was 8.2 months in the expired group and 3.7 months in the transplanted group (P = .012). In the expired group, the mean survival time was significantly shorter among patients with ARDS (2.2 months, P = .004) compared to IPF (7.9 months), COPD (10.7 months), and primary pulmonary hypertension (PPH) (30.0 months). The high mortality rate (42.5%) during the waiting period in Korea may result from the lack of donors and the delay in registration.
终末期肺病的肺移植可延长实际生存时间并改善肺功能。然而，供肺短缺一直是移植的主要限制因素。本研究的目的是分析每种疾病实体的等待时间和死亡率。对1996年5月至2011年5月在韩国器官共享网络（KONOS）登记的所有患者的病历进行分析，以确定等待时间和死亡原因。在研究期间，146例患者（86例男性和60例女性），平均年龄46.6岁（范围5至73岁），患有特发性肺纤维化（IPF；n = 61）、慢性阻塞性肺疾病（COPD；n = 19）或支气管扩张症（n = 15）。65例患者（44.5%）接受了肺或心肺移植。62例患者（42.5%）在等待期间死亡，19例患者仍在等待名单上。等待期间死亡率最高的是原发性肺动脉高压患者（62.5%），其次是IPF（57.4%）和急性呼吸窘迫综合征（ARDS）（55.6%）。在死亡患者中，从诊断到在KONOS登记的平均时间为15.5个月，移植组为13.2个月（P = 0.455）。在等待名单上的平均时间，死亡组为8.2个月，移植组为3.7个月（P = 0.012）。在死亡组中，ARDS患者的平均生存时间（2.2个月，P = 0.004）明显短于IPF（7.9个月）、COPD（10.7个月）和原发性肺动脉高压（PPH）（30.0个月）患者。韩国等待期间的高死亡率（42.5%）可能是由于供体短缺和登记延迟所致。
