Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
Department of Thoracic Surgery, Fujita Health University School of Medicine, Toyoake, Japan.
PLoS One. 2020 May 29;15(5):e0233804. doi: 10.1371/journal.pone.0233804. eCollection 2020.
We developed an ex vivo lung CT (EVL-CT) technique that allows us to obtain detailed CT images and morphologically assess the retrieved lung from a donor for transplantation. After we recovered the lung graft from a brain-dead donor, we transported it to our hospital and CT images were obtained ex vivo before lung transplant surgery. The objective of this study was to investigate the correlation between the EVL-CT findings and post-transplant outcome in patients who underwent bilateral lung transplantation (BLT) or single lung transplantation (SLT).
We retrospectively reviewed the records of 70 patients with available EVL-CT data who underwent BLT (34 cases) or SLT (36 cases) in our hospital between October 2007 and September 2017. The recipients were divided into 2 groups (control group, infiltration group) according to the findings of EVL-CT of the lung graft in BLT and SLT, respectively. Recipients in the control group were transplanted lung grafts without any infiltrates (BLT control group, SLT control group). Recipients in the infiltration group received lung grafts with infiltrates (BLT infiltration group, SLT infiltration group).
The recipients in the BLT infiltration group showed significantly slower recovery from primary graft dysfunction and a longer mechanical ventilation period and ICU stay period than those in the BLT control group. The mechanical ventilation period was significantly longer in the recipients in the SLT infiltration group than those in the SLT control group.
EVL-CT may predict the outcome of the early phase after lung transplantation.
我们开发了一种离体肺 CT（EVL-CT）技术，该技术使我们能够获得详细的 CT 图像，并对供体移植的肺进行形态评估。从脑死亡供体中取回肺移植物后，我们将其运送到我院，并在肺移植手术前进行离体 CT 检查。本研究的目的是探讨接受双侧肺移植（BLT）或单侧肺移植（SLT）的患者，EVL-CT 检查结果与移植后结果之间的相关性。
我们回顾性分析了 2007 年 10 月至 2017 年 9 月期间在我院接受 BLT（34 例）或 SLT（36 例）且有 EVL-CT 数据的 70 例患者的病历。根据 BLT 和 SLT 中肺移植物 EVL-CT 的发现，将受者分为 2 组（对照组、浸润组）。对照组接受无浸润的肺移植物（BLT 对照组、SLT 对照组）。浸润组接受有浸润的肺移植物（BLT 浸润组、SLT 浸润组）。
BLT 浸润组患者从原发性移植物功能障碍中恢复较慢，机械通气时间和 ICU 住院时间也较长，明显长于 BLT 对照组。SLT 浸润组患者的机械通气时间明显长于 SLT 对照组。
EVL-CT 可能预测肺移植后早期的结果。
