Hayes Don, McCoy Karen S, Whitson Bryan A, Mansour Heidi M, Tobias Joseph D
Department of Pediatrics, The Ohio State University, Columbus, OH, USA; Department of Internal Medicine, The Ohio State University, Columbus, OH, USA; Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
Pediatr Transplant. 2015 Mar;19(2):206-10. doi: 10.1111/petr.12401. Epub 2014 Nov 28.
LTx in children with CF remains controversial. The UNOS database was queried from 1987 to 2013 for CF patients <18 yr of age at time of transplant. PCHR model was used to quantify hazard of mortality. 489 recipients were included in the survival analysis. The hazard function of post-transplant mortality was plotted over attained age to identify age window of highest risk, which was 16-20 yr. Unadjusted PCHR model revealed ages immediately after the high-risk window were characterized by lower hazard of mortality (HR = 0.472; 95% CI = 0.302, 0.738; p = 0.001). After adjusting for potential confounders, the decline in mortality hazard immediately after the high-risk window remained statistically significant (HR = 0.394; 95% CI: 0.211, 0.737; p = 0.004). Hazard of mortality in children with CF after LTx was highest between 16 and 20 yr of attained age and declined thereafter.
囊性纤维化（CF）患儿的肺移植（LTx）仍存在争议。对1987年至2013年期间联合国器官共享网络（UNOS）数据库中移植时年龄小于18岁的CF患者进行了查询。采用比例累积危险率（PCHR）模型来量化死亡风险。489名受者纳入生存分析。绘制移植后死亡的危险函数与达到的年龄关系图，以确定最高风险的年龄窗口，即16 - 20岁。未调整的PCHR模型显示，高风险窗口之后紧接着的年龄段死亡风险较低（风险比[HR]=0.472；95%置信区间[CI]=0.302, 0.738；p = 0.001）。在对潜在混杂因素进行调整后，高风险窗口之后紧接着的年龄段死亡风险的下降在统计学上仍具有显著意义（HR = 0.394；95% CI：0.211, 0.737；p = 0.004）。CF患儿肺移植后达到16至20岁时死亡风险最高，此后下降。
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