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[结缔组织病相关间质性肺疾病受者的肺移植]

[Lung transplantation for connective tissue disease-associated interstitial lung disease recipient].

作者信息

Zhang J, Wu B, Zhou M, Liu D, Fan L, Wei D, Yang H, Chen J Y

机构信息

Transplantation Center of Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2017 Oct 12;40(10):744-748. doi: 10.3760/cma.j.issn.1001-0939.2017.10.007.

Abstract

To investigate the timing and complications of lung transplantation for the treatment of connective tissue disease-associated interstitial lung disease (CTD-ILD). The clinical data of connective tissue-associated disease lung transplantation recipients from September, 2015 to February, 2017 were collected. 11 patients with CTD-ILD were evaluated by lung transplantation and were treated with lung transplantation. Including 2 cases dermatomyositis/polymyositis and interstitial lung disease (PM/DM-ILD), 4 cases rheumatoid arthritis and interstitial lung disease (RA-ILD), 4 cases of primary Sjgren's syndrome and interstitial lung disease (pSS-ILD), 1 case of systemic sclerosis and interstitial lung disease (SSc-ILD). There are 6 cases are CTD-ILD-PAH patients of all. There were 5 males and 6 females, aged 37-70 years, with an average age of (52.73±9.53) years. 7 patients received single lung transplantation, 4 patients received double lung transplantation. 3 patients died in the early postoperative period, one for pulmonary embolism, one for septic shock and heart failure, one for severe primary graft failure (PGD). The remaining patients were followed up (4-24 months) with good survival, no acute and chronic rejection and other complications were observed. The survival rate was similar to that of other disease sources. There is no recurrence, acute and chronic rejection and other complications were observed in CTD-ILD and/or PAH lung transplant recipients. And the survival rate was comparable to that of other disease sources.Lung transplantation is a safe and effective choice for selected CTD-ILD patients.

摘要

探讨结缔组织病相关间质性肺疾病(CTD-ILD)肺移植的时机及并发症。收集2015年9月至2017年2月结缔组织病相关肺移植受者的临床资料。11例CTD-ILD患者接受了肺移植评估并接受了肺移植治疗。其中包括2例皮肌炎/多肌炎合并间质性肺疾病(PM/DM-ILD)、4例类风湿关节炎合并间质性肺疾病(RA-ILD)、4例原发性干燥综合征合并间质性肺疾病(pSS-ILD)、1例系统性硬化症合并间质性肺疾病(SSc-ILD)。所有患者中有6例为CTD-ILD-PAH患者。患者共5男6女,年龄37-70岁,平均年龄(52.73±9.53)岁。7例患者接受单肺移植,4例患者接受双肺移植。3例患者在术后早期死亡,1例死于肺栓塞,1例死于感染性休克和心力衰竭,1例死于严重原发性移植肺功能障碍(PGD)。其余患者获随访(4-24个月),存活良好,未观察到急慢性排斥反应及其他并发症。生存率与其他疾病来源相似。CTD-ILD和/或PAH肺移植受者未观察到复发、急慢性排斥反应及其他并发症。且生存率与其他疾病来源相当。对于选定的CTD-ILD患者,肺移植是一种安全有效的选择。

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