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, Yonsei University College of Medicine, Seoul, Korea.
Transplant Proc. 2012 May;44(4):870-4. doi: 10.1016/j.transproceed.2011.12.060.
Lung transplantation for end-stage lung disease results in prolonged survival and improved pulmonary function. However, the shortage of donor lungs has been a major limiting factor in Korea. We sought to investigate the number and utilization of donor lungs by the five institutions performing LTx in Korea, retrospectively reviewing outcomes of organs registered in the Korean Network for Organ Sharing from January to December, 2010. Lungs were offered from 270 brain-dead patients (189 males and 81 females) of mean age of 45.2 ± 14.2 years (range, 12 to 77 years). The most common cause of brain death was hemorrhage (n = 219, 81%). Only 18 (6.7%) donor lungs were used, which was low compared with kidney (93.3%), liver (86.3%), heart (26.7%), and pancreas (11.1%) use. The mean age of donors of transplanted lungs was 35.7 years (range, 14 to 51 years) compared with 45.9 years for other organs (P = .003). The characteristics of utilized donor lungs were: mean partial pressure of oxygen (PaO(2)), 300.9 mm Hg; mean smoking history, as 2.7 pack-years; and mean body mass index, 21.2 kg/m(2). The causes of refusal were medical ineligibility (n = 129) including poor PaO(2), abnormal chest x-ray, long smoking history, older age (n = 46), no properly matched recipient (n = 46), unknown (n = 17), and family withdrawal (n = 14). Only 8 (33.3%) were transplanted from standard criteria and 10 from the lungs that did not satisfy these criteria. An efficient utilization system is needed to improve lung transplantations.
终末期肺病的肺移植可延长生存期并改善肺功能。然而，供肺短缺一直是韩国的一个主要限制因素。我们试图调查韩国进行肺移植的五家机构的供肺数量及利用情况，回顾性分析2010年1月至12月在韩国器官共享网络登记的器官的结果。供肺来自270例脑死亡患者（189例男性和81例女性），平均年龄45.2±14.2岁（范围12至77岁）。脑死亡的最常见原因是出血（n = 219，81%）。仅18例（6.7%）供肺被使用，与肾（93.3%）、肝（86.3%）、心脏（26.7%）和胰腺（11.1%）的利用率相比很低。移植肺供者的平均年龄为35.7岁（范围14至51岁），而其他器官供者的平均年龄为45.9岁（P = 0.003）。被利用的供肺的特征为：平均氧分压（PaO₂）300.9 mmHg；平均吸烟史2.7包年；平均体重指数21.2 kg/m²。拒绝的原因包括医学上不符合条件（n = 129），如PaO₂低、胸部X光异常、吸烟史长、年龄大（n = 46）、没有合适匹配的受者（n = 46）、不明（n = 17）和家属撤回（n = 14）。仅8例（33.3%）来自标准标准的供肺，10例来自不符合这些标准的供肺。需要一个有效的利用系统来改善肺移植。
