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气道并发症对活体供体肺叶移植受者预后的影响比对尸体肺移植受者的影响更大。

Airway complications have a greater impact on the outcomes of living-donor lobar lung transplantation recipients than cadaveric lung transplantation recipients.

作者信息

Sugimoto Seiichiro, Yamane Masaomi, Otani Shinji, Kurosaki Takeshi, Okahara Shuji, Hikasa Yukiko, Toyooka Shinichi, Kobayashi Motomu, Oto Takahiro

机构信息

Department of General Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.

Department of Organ Transplant Center, Okayama University Hospital, Okayama, Japan.

出版信息

Surg Today. 2018 Sep;48(9):848-855. doi: 10.1007/s00595-018-1663-6. Epub 2018 Apr 21.

Abstract

PURPOSE

Airway complications (ACs) after living-donor lobar lung transplantation (LDLLT) could have different features from those after cadaveric lung transplantation (CLT). We conducted this study to compare the characteristics of ACs after LDLLT vs. those after CLT and investigate their impact on outcomes.

METHODS

We reviewed, retrospectively, data on 163 recipients of lung transplantation, including 83 recipients of LDLLT and 80 recipients of CLT.

RESULTS

The incidence of ACs did not differ between LDLLT and CLT. The initial type of AC after LDLLT was limited to stenosis in all eight patients, whereas that after CLT consisted of stenosis in three patients and necrosis in ten patients (p = 0.0034). ACs after LDLLT necessitated significantly earlier initiation of treatment than those after CLT (p = 0.032). The overall survival rate of LDLLT recipients with an AC was significantly lower than that of those without an AC (p = 0.030), whereas the overall survival rate was comparable between CLT recipients with and those without ACs (p = 0.25).

CONCLUSION

ACs after LDLLT, limited to bronchial stenosis, require significantly earlier treatment and have a greater adverse impact on survival than ACs after CLT.

摘要

目的

活体供者肺叶移植(LDLLT)后的气道并发症(ACs)可能具有与尸体肺移植(CLT)后不同的特征。我们开展这项研究以比较LDLLT后与CLT后ACs的特征,并研究它们对预后的影响。

方法

我们回顾性分析了163例肺移植受者的数据,其中包括83例LDLLT受者和80例CLT受者。

结果

LDLLT和CLT的ACs发生率无差异。LDLLT后最初的AC类型在所有8例患者中均为狭窄,而CLT后最初的AC类型包括3例狭窄和10例坏死(p = 0.0034)。LDLLT后的ACs比CLT后的ACs需要更早开始治疗(p = 0.032)。发生AC的LDLLT受者的总体生存率显著低于未发生AC的受者(p = 0.030),而CLT受者中发生AC与未发生AC的总体生存率相当(p = 0.25)。

结论

LDLLT后的ACs仅限于支气管狭窄,比CLT后的ACs需要更早治疗,且对生存有更大的不利影响。

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