Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA.
Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
Clin Transplant. 2018 Aug;32(8):e13307. doi: 10.1111/ctr.13307. Epub 2018 Jun 25.
Lung transplant remains an established treatment for end-stage lung disease, but limited organ availability remains a major barrier and contributor to waitlist mortality.1 Only 20% of available organs are considered suitable for lung transplantation (Am J Transplant, 16, 2016 and 141; Thorac Surg Clin, 25, 2015 and 35). Successful lung transplantation has been reported from donors infected with bacterial or fungal organisms, but there is a paucity of evidence regarding the use of donors with bacterial meningitis (Transplant Proc, 32, 2000 and 75; Transplantation, 64, 1997 and 365; Ann Thorac Surg, 86, 2008 and 1554).
The Cleveland Clinic lung transplant database was retrospectively reviewed for patients between January 1998 and December 2014. Post-transplantation outcomes collected included graft dysfunction, infectious complications, and survival.
The recipients were identified as having lungs from donors with bacterial meningitis. All recipients remained free of infectious organisms responsible for bacterial meningitis related in the donor. Severe primary graft dysfunction (PGD) was not seen in these recipients.
In our study, lung transplantation from increased risk donors with bacterial meningitis was not associated with an increased risk of early infectious complications in recipients. Donors with bacterial meningitis should be considered for lung donation and may expand the donor pool safely.
肺移植仍然是治疗终末期肺病的一种既定方法，但器官的有限供应仍然是一个主要的障碍，并导致等待名单上的死亡率居高不下。只有 20%的可用器官被认为适合进行肺移植（美国移植杂志，2016 年，第 16 卷，第 141 期；胸外科临床，2015 年，第 25 卷，第 35 期）。已有报道称，从感染细菌或真菌的供体中成功进行了肺移植，但关于使用患有细菌性脑膜炎的供体的证据很少（移植程序，2000 年，第 32 卷，第 75 期；移植，1997 年，第 64 卷，第 365 期；胸外科年鉴，2008 年，第 86 卷，第 1554 期）。
回顾性分析了 1998 年 1 月至 2014 年 12 月期间克利夫兰诊所的肺移植数据库。收集的移植后结果包括移植物功能障碍、感染并发症和存活率。
受者被确定为从患有细菌性脑膜炎的供体获得的肺。所有受者均未出现供体中导致细菌性脑膜炎的感染病原体。这些受者未出现严重原发性移植物功能障碍（PGD）。
在我们的研究中，从患有细菌性脑膜炎的高风险供体进行肺移植与受者早期感染并发症风险增加无关。患有细菌性脑膜炎的供体应被视为肺捐献的候选者，并且可以安全地扩大供体库。
