Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN; Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH.
Am J Transplant. 2015 Jan;15 Suppl 2:1-28. doi: 10.1111/ajt.13200.
Lungs are allocated to adult and adolescent transplant candidates (aged ⩾ 12 years) on the basis of age, geography, blood type compatibility, and the lung allocation score (LAS), which reflects risk of waitlist mortality and probability of posttransplant survival. In 2013, the most adult candidates, 2394, of any year were added to the list. Overall median waiting time for candidates listed in 2013 was 4.0 months. The preferred procedure remained bilateral lung transplant, representing approximately 70% of lung transplants in 2013. Measures of short-term and longterm survival have plateaued since the implementation of the LAS in 2005. The number of new child candidates (aged 0-11 years) added to the lung transplant waiting list increased to 39 in 2013. A total of 28 lung transplants were performed in child recipients, 3 for ages younger than 1 year, 9 for ages 1 to 5 years, and 16 for ages 6 to 11 years. The diagnosis of pulmonary hypertension was associated with higher survival rates than cystic fibrosis or other diagnosis (pulmonary fibrosis, bronchiolitis obliterans, bronchopulmonary dysplasia). For child candidates, infection was the leading cause of death in year 1 posttransplant and graft failure in years 2 to 5.
肺根据年龄、地理位置、血型相容性和肺分配评分(LAS)分配给成人和青少年移植候选者(年龄 ⩾ 12 岁),这反映了等待名单死亡率的风险和移植后生存的可能性。2013 年,加入名单的最多年龄较大的候选者为 2394 人。2013 年列出的候选者的总体中位等待时间为 4.0 个月。首选的程序仍然是双侧肺移植,代表 2013 年肺移植的大约 70%。自 2005 年实施 LAS 以来,短期和长期生存率的衡量标准已经趋于稳定。2013 年,新增儿童候选者(年龄 0-11 岁)人数增加到 39 人。共有 28 名儿童接受了肺移植,其中 3 名年龄小于 1 岁,9 名年龄为 1 至 5 岁,16 名年龄为 6 至 11 岁。肺动脉高压的诊断与囊性纤维化或其他诊断(肺纤维化、闭塞性细支气管炎、支气管肺发育不良)相比,生存率更高。对于儿童候选者,感染是移植后 1 年内死亡的主要原因,移植物衰竭发生在 2 至 5 年内。