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伊朗肺移植术后生存相关的危险因素。

Risk factors associated with survival after lung transplant in iran.

作者信息

Hosseini Baharanchi Fatemeh Sadat, Hajizadeh Ebrahim, Najafizadeh Katayoun, Baghestani Ahmad Reza, Shafaghi Shadi

机构信息

From the Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

出版信息

Exp Clin Transplant. 2014 Aug;12(4):290-4. doi: 10.6002/ect.2014.0029. Epub 2014 May 19.

Abstract

OBJECTIVES

Limited information is available about risk factors associated with survival after lung transplant in Iranian recipients. This study evaluated the effect of recipient and donor characteristics on survival after lung transplant.

MATERIALS AND METHODS

This retrospective study included 69 lung transplants (single, 31 patients [45%]; bilateral, 38 patients [55%]), from 2000 to 2013, at the National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. The Kaplan-Meier method was used to calculate survival, and variables were evaluated with multivariate analysis.

RESULTS

There were 54 male recipients (78%), and the most frequent indications for transplant included pulmonary fibrosis in 31 patients (45%) and bronchiectasis in 23 patients (33%). Recipient mean age was 36 ± 13 years and body mass index was 20 ± 4 kg/m2. Mean half-life (all recipients) was 2 ± 1 years and survival was 73% at 1 month, 67% at 1 year, and 40% at 5 years after transplant. For recipients who survived > 2 weeks after transplant half-life and survival were similar to previously international reported results. Recipient age, sex, type of transplant, body mass index, and pulmonary artery pressure were not associated with survival. Survival was significantly higher with recipient bronchiectasis, younger donors, and female donors.

CONCLUSIONS

Survival after lung transplant was better with recipients who had bronchiectasis and donors that were younger or female. Patient selection, invasive monitoring, and supportive techniques such as extracorporeal membrane oxygenation for unstable patients during surgery may be helpful.

摘要

目的

关于伊朗肺移植受者肺移植术后生存相关危险因素的信息有限。本研究评估了受者和供者特征对肺移植术后生存的影响。

材料与方法

这项回顾性研究纳入了2000年至2013年在伊朗德黑兰沙希德·贝赫什提医科大学马西·达内什瓦里医院国家结核病和肺部疾病研究所进行的69例肺移植手术(单肺移植,31例患者[45%];双肺移植,38例患者[55%])。采用Kaplan-Meier法计算生存率,并通过多变量分析评估变量。

结果

有54名男性受者(78%),最常见的移植指征包括31例患者(45%)的肺纤维化和23例患者(33%)的支气管扩张。受者平均年龄为36±13岁,体重指数为20±4kg/m²。平均半衰期(所有受者)为2±1年,移植后1个月生存率为73%,1年生存率为67%,5年生存率为40%。对于移植后存活超过2周的受者,半衰期和生存率与之前国际报道的结果相似。受者年龄、性别、移植类型、体重指数和肺动脉压与生存率无关。支气管扩张的受者、较年轻的供者和女性供者的生存率显著更高。

结论

支气管扩张的受者以及较年轻或女性供者的肺移植术后生存率更高。患者选择、侵入性监测以及在手术期间对不稳定患者采用体外膜肺氧合等支持技术可能会有所帮助。

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