Mohite Prashant N, Zych Bartlomiej, Sabashnikov Anton, Popov Aron-Frederik, Garcia-Saez Diana, Patil Nikhil P, Koch Achim, Zeriouh Mohamed, Rahmanian Parwis B, Dhar Dhruva, Amrani Mohamed, Bahrami Toufan, DeRobertis Fabio, Carby Martin, Reed Anna, Simon Andre R
Department of Cardiothoracic Transplantation & Mechanical Circulatory Support, Harefield Hospital, Royal Brompton and Harefield NHS Foundation Trust, Harefield, Middlesex, UK.
Clin Transplant. 2016 Apr;30(4):421-8. doi: 10.1111/ctr.12704. Epub 2016 Feb 23.
Limited data are available about lung transplantation (LTx) from donors suffering cardiac arrest (CA) prior to actual donation.
A retrospective analysis of LTx performed between January 2007 and September 2012 was done with the focus on CA in donors. The recipients were grouped depending on the history of donor CA and CA duration (downtime) as: No cardiac arrest ("NoCA"), CA downtime less than 20 min ("CA < 20"), and CA downtime equal to or more than 20 min ("CA > 20"). Early and mid-term outcomes after LTx were compared among the three groups.
A total of 237 LTx were performed during the study period. One hundred eighty-eight patients received organs from "NoCA" donors, 25 from "CA < 20" donors, and 24 patients from "CA > 20" donors. There was a trend toward better overall cumulative survival in both CA groups (log rank p = 0.076) whereas the survival in the "CA > 20" group was significantly better than in the "NoCA" group in the subgroup analysis (log rank p = 0.045). Freedom from bronchiolitis obliterans syndrome (BOS) also increased with increase in CA duration, although it did not reach statistical significance.
Transplantation of lungs from donors with a history of CA is safe and feasible. Longer duration of cardiac arrest may improve the outcomes after the LTx in terms of survival and freedom from BOS.
关于实际捐赠前经历心脏骤停（CA）的供体进行肺移植（LTx）的数据有限。
对2007年1月至2012年9月期间进行的LTx进行回顾性分析，重点关注供体的CA情况。根据供体CA病史和CA持续时间（停机时间）将受者分为：无心脏骤停（“无CA”）、CA停机时间少于20分钟（“CA < 20”）和CA停机时间等于或超过20分钟（“CA > 20”）。比较三组LTx后的早期和中期结果。
研究期间共进行了237例LTx。188例患者接受了“无CA”供体的器官，25例接受了“CA < 20”供体的器官，24例患者接受了“CA > 20”供体的器官。两个CA组的总体累积生存率均有更好的趋势（对数秩检验p = 0.076），而在亚组分析中，“CA > 20”组的生存率明显优于“无CA”组（对数秩检验p = 0.045）。闭塞性细支气管炎综合征（BOS）的发生率也随着CA持续时间的增加而增加，尽管未达到统计学意义。
有CA病史的供体的肺移植是安全可行的。较长的心脏骤停持续时间可能会在生存和免于BOS方面改善LTx后的结果。
