Sugimoto Seiichiro, Kurosaki Takeshi, Otani Shinji, Tanaka Shin, Hikasa Yukiko, Yamane Masaomi, Toyooka Shinichi, Kobayashi Motomu, Oto Takahiro
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.
Surg Today. 2019 Mar;49(3):254-260. doi: 10.1007/s00595-018-1730-z. Epub 2018 Oct 27.
When patients are mechanically ventilated for more than 5 days, they are usually declined as donors for lung transplantation (LTx); thus, the long-term outcomes of LTx from such donors remain unclear. We investigated the feasibility of LTx from donors that had been mechanically ventilated for prolonged periods.
The subjects of this retrospective comparative investigation were 31 recipients of LTx from donors who had been mechanically ventilated for < 5 days (short-term group) and 50 recipients of LTx from donors who had been mechanically ventilated for ≥ 5 days (long-term group).
The median duration of donor mechanical ventilation was 3 days in the short-term group and 8.5 days in the long-term group. However, other than the difference in the duration of donor ventilation, there were no significant differences in the clinical characteristics of the donors or recipients between the groups. The overall survival rate after LTx was comparable between the long-term group and short-term group (5-year survival rate, 66.6% vs. 75.2%).
The potential inclusion of donors who have been on mechanical ventilation for more than 5 days could be a feasible strategy to alleviate donor organ shortage.
当患者接受机械通气超过5天时,他们通常会被拒绝作为肺移植(LTx)的供体;因此,来自此类供体的肺移植长期结果仍不明确。我们研究了使用长期接受机械通气的供体进行肺移植的可行性。
这项回顾性比较研究的对象为31例接受来自机械通气时间<5天的供体的肺移植受者(短期组)和50例接受来自机械通气时间≥5天的供体的肺移植受者(长期组)。
短期组供体机械通气的中位持续时间为3天,长期组为8.5天。然而,除了供体通气持续时间的差异外,两组之间供体或受者的临床特征没有显著差异。肺移植后的总体生存率在长期组和短期组之间相当(5年生存率,66.6%对75.2%)。
纳入机械通气超过5天的供体可能是缓解供体器官短缺的一种可行策略。