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药物滥用供体肺移植的应用:对生存结局的影响。

Use of drug intoxicated donors for lung transplant: Impact on survival outcomes.

机构信息

Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA.

Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY, USA.

出版信息

Clin Transplant. 2018 May;32(5):e13252. doi: 10.1111/ctr.13252. Epub 2018 May 7.

DOI:10.1111/ctr.13252
PMID:29633364
Abstract

INTRODUCTION

The number of increasing deaths due to the opioid epidemic has led to a potential greater supply of organ donors. There is hesitancy to use drug intoxicated donors, and we evaluated their impact on post-transplant survival.

BACKGROUND

Patients ≥18 years of age undergoing lung transplantation and donors from whom at least one organ was donated between January 2005 and March 2015 were selected from the United Network of Organ Sharing database. Baseline characteristics and post-transplant survival were compared between drug intoxicated and all other donors.

RESULTS

The utilization of drug intoxicated donors increased from 1.86% in 2005 to 6.23% in 2014. The 2 study groups had similar characteristics including age, gender, and Lung Allocation Score. As compared to all other donors, drug intoxicated donors were younger (29.1 ± 9.4 vs 34.6 ± 13.4 years, P < .0001), less likely to be male (52% vs 61%, P < .0001), and had a greater smoking history (14% vs 11%, P .04). There was no difference in post-lung transplant survival at 1, 3, and 5 years between drug intoxicated donors (85%, 64%, and 47%) and non-drug intoxicated donors (83%, 65%, and 51%).

CONCLUSION

Transplantation utilizing drug intoxicated donor lungs has significantly increased over the past decade without significantly impacting post-transplant survival.

摘要

引言

阿片类药物泛滥导致的死亡人数不断增加,这可能导致可供移植的器官数量增加。人们对使用吸毒者捐献的器官存在顾虑,我们评估了这些器官对移植后存活的影响。

背景

我们从美国器官共享网络数据库中选取了 2005 年 1 月至 2015 年 3 月期间年龄≥18 岁、接受肺移植且至少有一个器官来自捐献者的患者。比较了吸毒者和所有其他捐献者的基线特征和移植后存活情况。

结果

吸毒者捐献者的使用率从 2005 年的 1.86%上升到 2014 年的 6.23%。两组的特征相似,包括年龄、性别和肺分配评分。与所有其他捐献者相比,吸毒者捐献者更年轻(29.1±9.4 岁 vs 34.6±13.4 岁,P<0.0001),男性比例更低(52% vs 61%,P<0.0001),吸烟史更重(14% vs 11%,P<.04)。吸毒者捐献者(1 年、3 年和 5 年的存活率分别为 85%、64%和 47%)和非吸毒者捐献者(1 年、3 年和 5 年的存活率分别为 83%、65%和 51%)的肺移植后存活情况无差异。

结论

在过去十年中,利用吸毒者捐献的肺进行移植的比例显著增加,但并未显著影响移植后的存活率。

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