Higo Hisao, Kurosaki Takeshi, Ichihara Eiki, Kubo Toshio, Miyoshi Kentaroh, Otani Shinji, Sugimoto Seiichiro, Yamane Masaomi, Miyahara Nobuaki, Kiura Katsuyuki, Miyoshi Shinichiro, Oto Takahiro
Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Department of Organ Transplant Center, Okayama University Hospital, Okayama, Japan.
Respir Investig. 2017 Jul;55(4):264-269. doi: 10.1016/j.resinv.2017.03.002. Epub 2017 Jun 22.
Lung transplants have produced very favorable outcomes for patients with interstitial lung disease (ILD) in Japan. However, because of the severe donor lung shortage, patients must wait approximately 2.5 years before they can undergo transplantation and many candidates die before allocation. We reveal the clinical characteristics of Japanese patients with ILD who are candidates for lung transplants and the risk factors for early death while on the waiting list.
We retrospectively reviewed the clinical data of patients registered in the Japan Organ Transplant Network from Okayama University Hospital who are candidates for cadaveric lung transplants for ILD between 1999 and 2015.
Fifty-three patients with ILD were included (24 patients with idiopathic pulmonary fibrosis and 29 others). They had severe pulmonary dysfunction and low exercise tolerability. The median waiting time for transplantation was 462 days, and 22 patients died before allocation. Patients who died before 462 days without undergoing transplantation had more severe dyspnea, shorter 6-minute walk distance (6MWD), and lower performance status than those who waited ≥462 days.
Japanese candidates for cadaveric lung transplants for ILD have severe pulmonary dysfunction. Severe dyspnea, short 6MWD, and low performance status are risk factors for early death while on the waiting list.
在日本，肺移植给间质性肺病（ILD）患者带来了非常良好的治疗效果。然而，由于供肺严重短缺，患者必须等待约2.5年才能接受移植，许多候选者在获得分配前就死亡了。我们揭示了日本ILD患者作为肺移植候选者的临床特征以及等待名单上早期死亡的危险因素。
我们回顾性分析了1999年至2015年间在日本器官移植网络中登记的、来自冈山大学医院的、作为尸体肺移植治疗ILD候选者的患者的临床资料。
纳入了53例ILD患者（24例特发性肺纤维化患者和其他29例）。他们有严重的肺功能障碍和低运动耐量。移植的中位等待时间为462天，22例患者在获得分配前死亡。在462天前未接受移植而死亡的患者比等待≥462天的患者有更严重的呼吸困难、更短的6分钟步行距离（6MWD）和更低的体能状态。
日本作为尸体肺移植治疗ILD候选者的患者有严重的肺功能障碍。严重的呼吸困难、短6MWD和低体能状态是等待名单上早期死亡的危险因素。
