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60岁及以上供体肺移植的早期和中期结果。

Early and mid-term results of lung transplantation with donors 60 years and older.

作者信息

López Iker, Zapata Ricardo, Solé Juan, Jaúregui Alberto, Deu María, Romero Laura, Pérez Javier, Bello Irene, Wong Manuel, Ribas Montse, Masnou Nuria, Rello Jordi, Roman Antonio, Canela Mercedes

机构信息

Department of Thoracic Surgery, Lung Transplant Unit, Vall d'Hebron University Hospital, Barcelona, Spain

Department of Thoracic Surgery, Lung Transplant Unit, Vall d'Hebron University Hospital, Barcelona, Spain.

出版信息

Interact Cardiovasc Thorac Surg. 2015 Jan;20(1):47-53. doi: 10.1093/icvts/ivu320. Epub 2014 Sep 25.

Abstract

OBJECTIVES

There are doubts about the age limit for lung donors and the ideal donor has traditionally been considered to be one younger than 55 years. The objective of this study was to compare the outcomes in lung transplantation between organs from donors older and younger than 60 years.

METHODS

We performed a retrospective observational study comparing the group of patients receiving organs from donors 60 years or older (Group A) or younger than 60 years (Group B) between January 2007 and December 2011. Postoperative evolution and mortality rates, short-term and mid-term postoperative complications, and global survival rate were evaluated.

RESULTS

We analysed a total of 230 lung transplants, of which 53 (23%) involved lungs from donors 60 years of age or older (Group A), and 177 (77%) were from donors younger than 60 years (Group B). Three (5.7%) patients from Group A and 14 patients (7.9%) from Group B died within 30 days (P = 0.58). The percentage of patients free from chronic lung allograft dysfunction at 1-3 years was 95.5, 74.3 and 69.3% for Group A, and 94.5, 84.8 and 73.3% for Group B, respectively (P = 0.47). There were no statistically significant differences between Groups A and B in terms of survival at 3 years, (69.4 vs 68.8%; P = 0.28).

CONCLUSIONS

Our results support the idea that lungs from donors aged 60-70 years can be used safely for lung transplantation with comparable results to lungs from younger donors in terms of postoperative mortality and mid-term survival.

摘要

目的

对于肺供体的年龄限制存在疑问,传统上认为理想的供体年龄小于55岁。本研究的目的是比较60岁及以上供体与60岁以下供体的肺移植结果。

方法

我们进行了一项回顾性观察研究,比较了2007年1月至2011年12月期间接受60岁及以上供体器官的患者组(A组)和接受60岁以下供体器官的患者组(B组)。评估术后病情进展、死亡率、短期和中期术后并发症以及总体生存率。

结果

我们共分析了230例肺移植手术,其中53例(23%)使用了60岁及以上供体的肺(A组),177例(77%)使用了60岁以下供体的肺(B组)。A组3例(5.7%)患者和B组14例(7.9%)患者在30天内死亡(P = 0.58)。A组1 - 3年无慢性肺移植功能障碍的患者百分比分别为95.5%、74.3%和69.3%,B组分别为94.5%、84.8%和73.3%(P = 0.47)。A组和B组在3年生存率方面无统计学显著差异(69.4%对68.8%;P = 0.28)。

结论

我们的结果支持这样一种观点,即60 - 70岁供体的肺可安全用于肺移植,在术后死亡率和中期生存率方面与年轻供体的肺效果相当。

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