York Barbara, Mann Brian, Jones Cathy, Orlowski Jeffrey P
The Center for Donation and Transplant, Albany, NY, USA.
Prog Transplant. 2012 Jun;22(2):207-11. doi: 10.7182/pit2012265.
Since 1998, lung transplants have increased almost 75%, making lung transplant the fastest growing form of organ transplant in the United States. However, the supply of transplantable lungs continues to fall short of the demand. Strategies for expanding the lung donor pool by increasing the number of older donor lungs used has been effective, although these donors do not meet typical clinical selection criteria based on age. In these older donors, effective communication of in-depth donor information is necessary to place and transplant lungs successfully. The following case study illustrates how an "every organ, every time" attitude combined with a technique to communicate clinical information resulted in the successful transplant of 72-year-old donor lungs into a bilateral lung recipient. Since the case outlined in this study, the organ procurement organization has successfully recovered and transplanted an additional 2 lungs from a 74-year-old and 1 lung from a 76-year-old, 2 of the oldest lung donors in the United States. This case demonstrates that although many older donor lungs are deemed unsuitable by clinical selection criteria, an extended criteria population offers an untapped resource for donor organs.
自1998年以来,肺移植数量增长了近75%,使肺移植成为美国增长最快的器官移植形式。然而,可用于移植的肺脏供应仍供不应求。通过增加使用老年供肺数量来扩大肺供体库的策略已见成效,尽管这些供体不符合基于年龄的典型临床选择标准。对于这些老年供体,有效地传达详细的供体信息对于成功安置和移植肺脏至关重要。以下案例研究说明了“每次利用每个器官”的态度与一种临床信息沟通技巧相结合,是如何成功地将一名72岁供体的肺脏移植给一名双侧肺脏受体的。自本研究中概述的案例以来,该器官获取组织又成功获取并移植了另外2个来自一名74岁供体的肺脏和1个来自一名76岁供体的肺脏,这两人是美国年龄最大的肺脏供体中的两位。该案例表明,尽管许多老年供肺根据临床选择标准被认为不合适,但扩大标准人群提供了一个尚未开发的供体器官资源。