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韩国某单一机构肺移植患者肺部的临床病理分析

Clinico-pathological Analysis of the Lungs from Patients with Lung Transplantation in a Single Institute in Korea.

作者信息

Kim Hyojin, Jeon Yoon Kyung, Lee Hyun Joo, Kim Young Tae, Chung Doo Hyun

机构信息

Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Department of Thoracic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

出版信息

J Korean Med Sci. 2015 Oct;30(10):1439-45. doi: 10.3346/jkms.2015.30.10.1439. Epub 2015 Sep 12.

Abstract

Recently, the numbers of lung transplantation (LT) has been increased in Korea. However, post-LT outcome has not been successful in all patients, which may be partially affected by the primary lung disease. Therefore comprehensive understanding in original pathological diagnosis of patients with LT would be needed for achieving better clinical outcome. To address this issue, we performed clinico-pathological analysis of the explanted lungs from 29 patients who underwent LT over a 9-yr period in Seoul National University Hospital. Among them, 26 patients received single (1/26) or double (25/26) LT, while heart-lung transplantation was performed in 3 patients. The final clinico-pathological diagnoses were idiopathic pulmonary fibrosis/usual interstitial pneumonia (UIP) (n = 6), acute interstitial pneumonia (AIP)/diffuse alveolar damage (DAD) (n = 4), AIP/non-specific interstitial pneumonia with DAD (n = 1), collagen vascular disease-related interstitial lung disease (CVD-ILD)/DAD (n = 3), CVD-ILD/UIP (n = 1), lymphangioleiomyomatosis (n = 1), bronchiectasis (n = 4), pulmonary arterial hypertension (n = 2), tuberculosis (n = 1), bronchiolitis obliterans (BO) (n = 1), and lung cancer (n = 1). Moreover, 4 patients who had chemotherapy and hematopoietic stem cell transplantation due to hematologic malignancy showed unclassifiable interstitial pneumonia with extensive fibrosis in the lungs. Our study demonstrates that pathology of the explanted lungs from Korean patients with LT is different from that of other countries except for interstitial lung disease and bronchiectasis, which may be helpful for optimization of selecting LT candidates for Korean patients.

摘要

近年来,韩国肺移植(LT)的数量有所增加。然而,并非所有患者的LT术后结果都很成功,这可能部分受到原发性肺部疾病的影响。因此,为了获得更好的临床结果,需要对LT患者的原始病理诊断有全面的了解。为了解决这个问题,我们对首尔国立大学医院9年间接受LT的29例患者的切除肺进行了临床病理分析。其中,26例患者接受了单肺移植(1/26)或双肺移植(25/26),3例患者接受了心肺移植。最终的临床病理诊断为特发性肺纤维化/普通型间质性肺炎(UIP)(n = 6)、急性间质性肺炎(AIP)/弥漫性肺泡损伤(DAD)(n = 4)、AIP/伴有DAD的非特异性间质性肺炎(n = 1)、胶原血管病相关间质性肺病(CVD-ILD)/DAD(n = 3)、CVD-ILD/UIP(n = 1)、淋巴管平滑肌瘤病(n = 1)、支气管扩张(n = 4)、肺动脉高压(n = 2)、肺结核(n = 1)、闭塞性细支气管炎(BO)(n = 1)和肺癌(n = 1)。此外,4例因血液系统恶性肿瘤接受化疗和造血干细胞移植的患者表现为无法分类的间质性肺炎,肺部有广泛纤维化。我们的研究表明,韩国LT患者的切除肺病理与其他国家不同,除了间质性肺病和支气管扩张,这可能有助于优化韩国患者LT候选者的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e1f/4575932/b4d0983a15d2/jkms-30-1439-g001.jpg

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