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器官获取与移植网络/器官共享联合网络2015年度数据报告:肺脏

OPTN/SRTR 2015 Annual Data Report: Lung.

作者信息

Valapour M, Skeans M A, Smith J M, Edwards L B, Cherikh W S, Uccellini K, Israni A K, Snyder J J, Kasiske B L

机构信息

Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.

Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH.

出版信息

Am J Transplant. 2017 Jan;17 Suppl 1:357-424. doi: 10.1111/ajt.14129.

Abstract

In 2015, 2409 active candidates aged 12 years or older were added to the lung transplant waiting list; 2072 transplants were performed, the most of any year. The median waiting time for candidates listed in 2015 was 3.4 months; the shortest waiting time was for diagnosis group D. Despite the highest recorded transplant rate of 157 per 100 waitlist years, waitlist mortality continued a steady decade-long rise to a high of 16.5 deaths per 100 waitlist years. Measures of short- and long-term survival showed no trend toward improved overall survival in the past 5 years, except that 6-month death rates decreased from 9.4% in 2005 to 7.9% in 2014. At 5 years posttransplant, 55.5% of recipients remained alive. In 2015, 23 new child (ages 0-11 years) candidates were added to the list; 17 transplants were performed. Incidence of death was 6.1% at 6 months and 8.2% at 1 year for transplants in 2013-2014. Important policy changes will affect access to transplant. In February 2015, OPTN implemented a comprehensive revision of the lung allocation score to better reflect mortality risk. Broader geographic sharing of donor lungs for pediatric candidates and allowance for selected transplants across blood types for candidates aged younger than 2 years have been approved and are expected to improve pediatric access to transplant. The impact of these changes on lung transplant trends will be observed in the coming years.

摘要

2015年,12岁及以上的2409名活跃候选人被加入肺移植等待名单;共进行了2072例移植手术,为历年之最。2015年列入等待名单的候选人的中位等待时间为3.4个月;诊断组D的等待时间最短。尽管记录的移植率达到了每100个等待名单年157例的最高水平,但等待名单死亡率在长达十年的时间里持续稳步上升,达到了每100个等待名单年16.5例死亡的高位。短期和长期生存指标显示,在过去5年中总体生存率没有改善趋势,不过6个月死亡率从2005年的9.4%降至2014年的7.9%。移植后5年,55.5%的受者仍然存活。2015年,23名新的儿童(0至11岁)候选人被加入名单;进行了17例移植手术。2013 - 2014年移植手术的6个月死亡率为6.1%,1年死亡率为8.2%。重要的政策变化将影响移植的可及性。2015年2月,器官获取与移植网络(OPTN)对肺分配评分进行了全面修订,以更好地反映死亡风险。扩大儿科候选人供体肺的地理共享范围以及允许2岁以下候选人进行跨血型的特定移植已获批准,预计将改善儿科患者获得移植的机会。这些变化对肺移植趋势的影响将在未来几年得到观察。

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