Li J W, Xu L, Han Z J, Wei L
Department of Thoracic Surgery, Henan Provincial People's Hospital, Zhengzhou 450003, China.
Zhonghua Yi Xue Za Zhi. 2018 May 22;98(19):1503-1506. doi: 10.3760/cma.j.issn.0376-2491.2018.19.010.
To explore the risk factors of primary graft dysfunction (PGD) after lung transplantation and provide a new therapeutic strategy for PGD. A retrospective analysis of lung transplant patients from January 2014 to July 2017 in Henan Provincial People's Hospital.According to the PGD classification standard established by the International Society for Heart and Lung Transplantation, the association of potential risk factors with PGD was analyzed by using multivariable Logistic regression. Fourteen of 30 patients (46.7%) developed grade 3 PGD.There was no significantly statistical difference in gender, etiology, duration of anesthesia, amount of blood transfusion, amount of blood transfusion and donor gender(all >0.05). Body mass index (BMI), donor pulmonary cold ischemia time, duration of operation, extracorporeal membrane lung oxygenator (ECMO), systolic pulmonary arterial pressure and donor smoking history were all higher than those of non-PGD patients (all <0.05). Independent risk factors for PGD were donor pulmonary cold ischemia time ( 1.032, 95% 1.000-1.065, =0.048); systolic pulmonary arterial pressure ( 1.258, 95% 0.969-1.632, =0.007); donor smoking ( 8.879, 95% 1.096-71.913, =0.041). Donor pulmonary ischemic time, systolic pulmonary arterial pressure and donor smoking history are PGD risk factors, which provide new ideas for PGD treatment.
探讨肺移植术后原发性移植肺功能障碍（PGD）的危险因素，为PGD提供新的治疗策略。对河南省人民医院2014年1月至2017年7月的肺移植患者进行回顾性分析。根据国际心肺移植学会制定的PGD分类标准，采用多变量Logistic回归分析潜在危险因素与PGD的关联。30例患者中有14例（46.7%）发生3级PGD。性别、病因、麻醉时间、输血量、供体性别差异均无统计学意义（均>0.05）。PGD患者的体重指数（BMI）、供体肺冷缺血时间、手术时间、体外膜肺氧合（ECMO）、收缩期肺动脉压和供体吸烟史均高于非PGD患者（均<0.05）。PGD的独立危险因素为供体肺冷缺血时间（1.032，95% 1.000 - 1.065，P = 0.048）；收缩期肺动脉压（1.258，95% 0.969 - 1.632，P = 0.007）；供体吸烟（8.879，95% 1.096 - 71.913，P = 0.041）。供体肺缺血时间、收缩期肺动脉压和供体吸烟史是PGD的危险因素，为PGD治疗提供了新思路。
