70 岁及以上肺移植受者的预后。
Outcomes after lung transplantation in recipients aged 70 years or older.
机构信息
Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
University of Arizona College of Medicine - Phoenix Campus, Phoenix, Arizona, USA.
出版信息
Clin Transplant. 2022 Jan;36(1):e14505. doi: 10.1111/ctr.14505. Epub 2021 Oct 26.
BACKGROUND
The proportion of lung transplant (LTx) recipients older than 70 years is increasing, thus we assessed long-term survival after LTx in this cohort relative to younger counterparts.
PATIENTS AND METHODS
We retrospectively reviewed charts of patients who underwent LTx between 2012 and 2016 at our center and divided patients by age: group A (<65 years), B (65-69 years), and C (≥70 years). Survival statistics were evaluated using the Kaplan-Meier method and Cox regression.
RESULTS
The study included 375 LTx recipients: 221 (58.9%) in group A, 109 (29.1%) in group B, and 45 (12.0%) in group C. Group C was mostly men (37/45 [82.2%]; P = 0.003) and had the highest mean serum creatinine at listing (P = 0.02). Survival at 1, 3, and 5 years after transplant in group A (93.2%, 70.1%, 58.8%) was significantly higher than group B (83.5%, 59.6%, 44.0%; P = 0.005, 0.028, 0.006, log-rank test) and was similar to group C (86.7%, 64.4%, 57.8%), although trended higher at 1 year (P = 0.139, 0.274, 0.489, log-rank test). Groups B and C had comparable survival at all time points.
CONCLUSIONS
Although survival decreased after age 65, long-term survival was comparable between LTx recipients aged 65-69 years and recipients ≥70 years.
背景
接受肺移植（LTx）的患者中 70 岁以上的比例正在增加，因此我们评估了该队列中与年轻患者相比，LTx 后的长期生存情况。
患者和方法
我们回顾性分析了 2012 年至 2016 年在我们中心接受 LTx 的患者的病历，并按年龄将患者分为三组：A 组（<65 岁）、B 组（65-69 岁）和 C 组（≥70 岁）。采用 Kaplan-Meier 方法和 Cox 回归评估生存统计数据。
结果
研究共纳入 375 例 LTx 受者：A 组 221 例（58.9%），B 组 109 例（29.1%），C 组 45 例（12.0%）。C 组患者多为男性（37/45 [82.2%]；P=0.003），且在列入名单时血清肌酐均值最高（P=0.02）。A 组患者在移植后 1、3 和 5 年的生存率（93.2%、70.1%、58.8%）明显高于 B 组（83.5%、59.6%、44.0%；P=0.005、0.028、0.006，log-rank 检验），与 C 组（86.7%、64.4%、57.8%）相似，尽管 1 年时略有升高（P=0.139、0.274、0.489，log-rank 检验）。B 组和 C 组在所有时间点的生存率相似。
结论
虽然 65 岁后生存率下降，但 65-69 岁与≥70 岁的 LTx 受者的长期生存率相当。
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