Ananiadou Olga, Schmack Bastian, Zych Bartlomiej, Sabashnikov Anton, Garcia-Saez Diana, Mohite Prashant, Weymann Alexander, Mansur Ashham, Zeriouh Mohamed, Marczin Nandor, De Robertis Fabio, Simon Andre Rüdiger, Popov Aron-Frederik
Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Harefield, United Kingdom Department of Anesthesiology, University Medical Center, Georg August University, Goettingen, Germany Faculty of Medicine, National Heart & Lung Institute, Imperial College, Heart Science Centre, Harefield Hospital, Harefield Section of Anaesthetics, Pain Medicine and Intensive Care, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom Department of Cardiothoracic Surgery, University of Frankfurt, Frankfurt, Germany.
Medicine (Baltimore). 2018 Apr;97(14):e0064. doi: 10.1097/MD.0000000000010064.
In the context of limited donor pool in cardiothoracic transplantation, utilization of organs from high risk donors, such as suicidal hanging donors, while ensuring safety, is under consideration. We sought to evaluate the outcomes of lung transplantations (LTx) that use organs from this group.Between January 2011 and December 2015, 265 LTx were performed at our center. Twenty-two recipients received lungs from donors after suicidal hanging (group 1). The remaining 243 transplantations were used as a control (group 2). Analysis of recipient and donor characteristics as well as outcomes was performed.No statistically significant difference was found in the donor characteristics between analyzed groups, except for higher incidence of cardiac arrest, younger age and smoking history of hanging donors (P < .001, P = .022 and P = .0042, respectively). Recipient preoperative and perioperative characteristics were comparable. Postoperatively in group 1 there was a higher incidence of extracorporeal life support (27.3 vs 9.1%, P = .019). There were no significant differences in chronic lung allograft dysfunction-free survival between group 1 and 2: 92.3 vs 94% at 1 year and 65.9 vs 75.5% at 3 years (P = .99). The estimated cumulative survival rate was also similar between groups: 68.2 vs 83.2% at 1 year and 68.2% versus 72% at 3 years (P = .3758).Hanging as a donor cause of death is not associated with poor mid-term survival or chronic lung allograft dysfunction following transplantation. These results encourage assessment of lungs from hanging donors, and their consideration for transplantation.
在心胸移植供体库有限的背景下,在确保安全的同时,正在考虑利用高风险供体的器官,如自杀性缢吊供体的器官。我们试图评估使用该组供体器官进行肺移植(LTx)的结果。2011年1月至2015年12月期间,我们中心进行了265例肺移植。22例受者接受了自杀性缢吊后供体的肺(第1组)。其余243例移植作为对照(第2组)。对受者和供体特征以及结果进行了分析。分析组之间的供体特征没有发现统计学上的显著差异,除了心脏骤停发生率较高、缢吊供体年龄较小和有吸烟史(分别为P<0.001、P = 0.022和P = 0.0042)。受者术前和围手术期特征具有可比性。第1组术后体外生命支持的发生率较高(27.3%对9.1%,P = 0.019)。第1组和第2组之间慢性肺移植功能障碍-free生存率没有显著差异:1年时为92.3%对94%,3年时为65.9%对75.5%(P = 0.99)。两组之间的估计累积生存率也相似:1年时为68.2%对83.2%,3年时为68.2%对72%(P = 0.3758)。作为供体死亡原因的缢吊与移植后中期生存率差或慢性肺移植功能障碍无关。这些结果鼓励对缢吊供体的肺进行评估,并考虑将其用于移植。