University Hospital Zurich Department of Thoracic Surgery, SWITZERLAND;
Swiss Med Wkly. 2013 Aug 22;143:w13836. doi: 10.4414/smw.2013.13836. eCollection 2013.
Lung transplantation is an established therapeutic option for end-stage lung disease in selected patients. During the last 30 years more than 34,000 transplantations have been performed worldwide. Emphysema, pulmonary fibrosis, cystic fibrosis and primary pulmonary hypertension are the most common indications. This type of surgical treatment is increasingly successful, with better early and late survival rates. However, lung transplantation is still hampered by persisting problems such as donor organ shortage, primary graft dysfunction, late graft dysfunction and morbidity related to long-term immunosuppression. The first lung transplantation in Switzerland was performed the 10th November 1992 at Zurich University Hospital. Since then the lung transplant programme has progressively increased its yearly transplant volume. Since the beginning of our lung transplantation programme, overall patient survival has increased steadily and has been at benchmark levels since the year 2000. The most important factors influencing this result are presumably good teamwork among all involved specialists, improved surgical techniques, and close and long-term patient follow-up by the transplant pulmonologists. In this paper we present our programme structure, managing strategies for some specific problems and outcome after lung transplantation. The results presented here are from recipients who underwent lung transplantation up to the end of 2011.
肺移植是治疗特定患者晚期肺部疾病的一种成熟治疗手段。在过去的 30 年中,全世界已经进行了超过 34000 例移植手术。肺气肿、肺纤维化、囊性纤维化和原发性肺动脉高压是最常见的适应证。这种类型的手术治疗越来越成功,早期和晚期存活率都有所提高。然而,肺移植仍然受到一些持续存在的问题的困扰,如供体器官短缺、原发性移植物功能障碍、晚期移植物功能障碍以及与长期免疫抑制相关的发病率。瑞士的首例肺移植于 1992 年 11 月 10 日在苏黎世大学医院进行。自那时以来,肺移植项目逐年增加其移植量。自我们的肺移植项目开始以来,总体患者存活率稳步上升,自 2000 年以来一直处于基准水平。影响这一结果的最重要因素可能是所有相关专家之间的良好团队合作、改进的手术技术以及移植肺科医生对患者的密切和长期随访。本文介绍了我们的项目结构、一些特定问题的管理策略以及肺移植后的结果。这里呈现的结果来自于截至 2011 年底接受肺移植的受者。