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土耳其肺移植供体的选择:是否有必要等待理想供体?

Donor selection for lung transplant in Turkey: Is it necessary to wait for an ideal donor?

作者信息

Vayvada Mustafa, Taşçı Ahmet Erdal

机构信息

Department of Thoracic Surgery, Kartal Koşuyolu High Specialization Training and Research Hospital, Istanbul, Türkiye.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2021 Jul 26;29(3):339-346. doi: 10.5606/tgkdc.dergisi.2021.19953. eCollection 2021 Jul.

Abstract

BACKGROUND

The aim of this study was to evaluate the donor criteria used in lung transplantation in our clinic.

METHODS

A total of 55 cadaveric donors who were accepted for lung transplantation in our clinic between December 2016 and January 2019 were retrospectively analyzed according to ideal donor criteria. The donors were divided into two groups as ideal and non-ideal ones according to their age, partial pressure of oxygen in arterial blood, history of smoking, and ventilation day. Donor data, recipient characteristics and survival outcomes were evaluated.

RESULTS

Of 55 donors accepted for lung transplantation, 24 (43.7%) were ideal and 31 (56.3%) were non-ideal donors. The 90-day mortality and one-year survival rates were not significantly different between the two groups. The 90-day mortality was 25% in the ideal group and 22.6% in the non-ideal group (p=0.834). The one-year survival rates after lung transplantation were 64.5% versus 70.6% in the ideal and non-ideal groups, respectively (p=0.444).

CONCLUSION

The whole clinical picture should be evaluated before accepting or rejecting donors for lung transplantation. The use of lung donors that do not meet the ideal criteria does not impair short- and mid-term results, compared to ideal lung donors. Strict implementation of donor criteria may prevent using suitable donors for lung transplantation. Use of non-ideal donors can reduce waiting list mortality.

摘要

背景

本研究旨在评估我院肺移植所采用的供体标准。

方法

回顾性分析2016年12月至2019年1月间我院接受肺移植的55例尸体供体,依据理想供体标准进行分析。根据年龄、动脉血氧分压、吸烟史及通气天数,将供体分为理想供体和非理想供体两组。对供体数据、受体特征及生存结局进行评估。

结果

在55例接受肺移植的供体中,24例(43.7%)为理想供体,31例(56.3%)为非理想供体。两组的90天死亡率和1年生存率无显著差异。理想组的90天死亡率为25%,非理想组为22.6%(p = 0.834)。肺移植后的1年生存率,理想组为64.5%,非理想组为70.6%(p = 0.444)。

结论

在接受或拒绝肺移植供体前,应全面评估整体临床情况。与理想肺供体相比,使用不符合理想标准的肺供体不会损害短期和中期结果。严格执行供体标准可能会阻碍使用合适的肺移植供体。使用非理想供体可降低等待名单上的死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc6d/8462116/671605ad92a8/TJTCS-2021-29-3-339-346-F1.jpg

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