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基于既往移植类型,单肺再移植与双肺再移植对生存率无影响。

Single Versus Double Lung Retransplantation Does Not Affect Survival Based on Previous Transplant Type.

作者信息

Schumer Erin M, Rice Jonathan D, Kistler Amanda M, Trivedi Jaimin R, Black Matthew C, Bousamra Michael, van Berkel Victor

机构信息

Department of Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, Kentucky.

Department of Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, Kentucky.

出版信息

Ann Thorac Surg. 2017 Jan;103(1):236-240. doi: 10.1016/j.athoracsur.2016.07.012. Epub 2016 Sep 24.

Abstract

BACKGROUND

Survival following retransplantation with a single lung is worse than after double lung transplant. We sought to characterize survival of patients who underwent lung retransplantation based on the type of their initial transplant, single or double.

METHODS

The United Network for Organ Sharing database was queried for adult patients who underwent lung retransplantation from 2005 onward. Patients were excluded if they underwent more than one retransplantation. The patient population was divided into 4 groups based on first followed by second transplant type, respectively: single then single, double then single, double then double, and single then double. Descriptive analysis and Kaplan-Meier survival analysis were performed. A p value less than 0.05 was considered significant.

RESULTS

A total of 410 patients underwent retransplantation in the study time period. Overall mean survival for all patients who underwent retransplantation was 1,213 days. Kaplan-Meier survival analysis demonstrated no difference in graft survival between the 4 study groups (p = 0.146).

CONCLUSIONS

There was no significant difference in graft survival between recipients of retransplant with single or double lungs when stratified by previous transplant type. These results suggest that when retransplantation is performed, single lung retransplantation should be considered, regardless of previous transplant type, in an effort to maximize organ resources.

摘要

背景

单肺再次移植后的生存率低于双肺移植。我们试图根据初次移植的类型(单肺或双肺)来描述接受肺再次移植患者的生存率。

方法

查询器官共享联合网络数据库中2005年以后接受肺再次移植的成年患者。如果患者接受了不止一次再次移植,则将其排除。根据初次移植类型,然后是第二次移植类型,将患者人群分为4组:单肺然后单肺、双肺然后单肺、双肺然后双肺、单肺然后双肺。进行描述性分析和Kaplan-Meier生存分析。p值小于0.05被认为具有统计学意义。

结果

在研究期间,共有410例患者接受了再次移植。所有接受再次移植患者的总体平均生存时间为1213天。Kaplan-Meier生存分析显示,4个研究组之间的移植物生存率无差异(p = 0.146)。

结论

根据既往移植类型进行分层时,单肺或双肺再次移植受者的移植物生存率无显著差异。这些结果表明,在进行再次移植时,无论既往移植类型如何,都应考虑单肺再次移植,以最大限度地利用器官资源。

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