Gao Fei, Wei Dong, Wu Bo, Zhou Min, Zhang Ji, Chen Jing-yu
Hematopoietic Stem Cell Transplantation Center, Wuxi People's Hospital, Wuxi 214023, China.
Zhonghua Xue Ye Xue Za Zhi. 2013 Aug;34(8):669-72. doi: 10.3760/cma.j.issn.0253-2727.2013.08.006.
To explore the feasibility and efficiency of lung transplantation in the treatment of bronchiolitis obliterans (BO) after allogeneic bone marrow transplantation (allo-BMT).
We reported one case of bilateral lung transplantation for BO after allo-BMT and reviewed the related literatures.
A 23 year-old man diagnosed as BO after allo-BMT underwent a sequential bilateral lung transplantation through bilateral anterolateral thoracotomy without sternal division. The patient suffered from acute rejection on post-operation day (POD) 2, and cured by mechanical ventilation, large dose of methylprednisolone and gamma globulin. The patient was transferred out of the intensive care unit on POD 14 and discharged from the hospital on POD 43. Chest CT scans and pulmonary function tests showed good performance in 3 and 6 months follow-up period.
BO is one of the late common non-infectious pulmonary complication after allo-BMT. For patients who have no response to medication, lung transplantation is the only efficient treatment choice so far, which can prolong survival and improve the quality of life. However, limited by small samples, optimal surgery time and appropriate care of postoperative complications still need accumulation of experience by multicenter and large samples studies.
探讨肺移植治疗异基因骨髓移植（allo-BMT）后闭塞性细支气管炎（BO）的可行性和有效性。
我们报道了1例allo-BMT后BO行双侧肺移植的病例，并复习相关文献。
1例23岁allo-BMT后诊断为BO的男性患者，经双侧前外侧开胸非劈开胸骨行序贯双侧肺移植。患者术后第2天发生急性排斥反应，经机械通气、大剂量甲泼尼龙和丙种球蛋白治疗治愈。患者术后第14天转出重症监护病房，术后第43天出院。胸部CT扫描和肺功能检查显示在3个月和6个月随访期效果良好。
BO是allo-BMT后常见的晚期非感染性肺部并发症之一。对于药物治疗无效的患者，肺移植是目前唯一有效的治疗选择，可延长生存期并改善生活质量。然而，受样本量小的限制，最佳手术时机及术后并发症的恰当处理仍需多中心大样本研究积累经验。
