Savi D, Mordenti M, Bonci E, Troiani P, Giordani B, D'Alù V, Bertasi S, Cimino G, Rossi P, Poggi C, Palange P, Quattrucci S
Department of Public Health and Infectious Diseases, Adult Cystic Fibrosis Center, Sapienza University of Rome, Italy; Cystic Fibrosis Unit, Bambino Gesù Children's Hospital, Rome, Italy.
Department of Public Health and Infectious Diseases, Adult Cystic Fibrosis Center, Sapienza University of Rome, Italy.
Transplant Proc. 2018 Dec;50(10):3732-3738. doi: 10.1016/j.transproceed.2018.08.020. Epub 2018 Sep 7.
Lung transplantation is currently the only treatment for end-stage respiratory failure in patients with cystic fibrosis (CF). In this study we retrospectively analyzed our experience since the start of the transplantation program in 1996 with focus on survival analysis.
All patients with CF who underwent lung transplant at our center were included (1996-2016). Survival analysis after lung transplant was performed using the Kaplan-Meier estimate, comparing by sex and by 4 eras (1996-2000, 2001-2005, 2006-2010, and 2011-2016).
In a 20-year period, 243 patients with CF were listed for lung transplant; 123 patients (61 male, 62 female) underwent transplant, and 85 died while waiting for donor organs. The mean (SD) and median age at transplant was 27.7 (8.7) years and 26.9 years (range, 9.1 - 52.1 years), respectively. Mean (SD) forced expiratory volume in the first second was 27.6 (9.7)% predicted; 115 patients (92.0%) were pancreatic insufficient, and 43 patients (34.0%) had CF-related diabetes. Removing patients with CF who died within the first 3 postoperative months, the mean (SD) and median survival after transplant were 8.2 (5.7) years and 7.5 years (range, 3 months-20 years), respectively. Overall post-lung transplant 1-year survival was 93.6%, 5-year survival was 71.4%, 10-year survival was 53.6%, 15-year survival was 36.7%, and 20-year survival was 31.6%. We found no difference in survival between sex (P = .22) and among the 4 eras (P = .56).
Survival after lung transplant in our single center is similar to international data.
肺移植是目前治疗囊性纤维化（CF）患者终末期呼吸衰竭的唯一方法。在本研究中，我们回顾性分析了自1996年移植项目启动以来的经验，重点是生存分析。
纳入所有在我们中心接受肺移植的CF患者（1996 - 2016年）。采用Kaplan-Meier估计法进行肺移植后的生存分析，并按性别和4个时期（1996 - 2000年、2001 - 2005年、2006 - 2010年和2011 - 2016年）进行比较。
在20年期间，243例CF患者被列入肺移植名单；123例患者（61例男性，62例女性）接受了移植，85例在等待供体器官时死亡。移植时的平均（标准差）年龄和中位年龄分别为27.7（8.7）岁和26.9岁（范围9.1 - 52.1岁）。第一秒用力呼气量的平均（标准差）预计值为27.6（9.7）%；115例患者（92.0%）存在胰腺功能不全，43例患者（34.0%）患有CF相关糖尿病。排除术后前3个月内死亡的CF患者后，移植后的平均（标准差）生存时间和中位生存时间分别为8.2（5.7）年和7.5年（范围3个月 - 20年）。肺移植后总体1年生存率为93.6%，5年生存率为71.4%，10年生存率为53.6%，15年生存率为36.7%，20年生存率为31.6%。我们发现性别之间（P = 0.22）以及4个时期之间（P = 0.56）的生存率无差异。
我们单中心肺移植后的生存率与国际数据相似。
