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肺移植治疗囊性纤维化患者的结果:一项单中心研究。

Results of Lung Transplantations Among Cystic Fibrosis Patients: A Single-Center Study.

机构信息

Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland.

Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland..

出版信息

Transplant Proc. 2022 May;54(4):1082-1085. doi: 10.1016/j.transproceed.2022.02.056. Epub 2022 Apr 29.

Abstract

BACKGROUND

Lung transplantation remains the ultimate treatment for patients who have exhausted all other therapeutic options in the course of end-stage lung disease due to cystic fibrosis (CF). The aim of the study was to assess the results of lung transplantations performed via mini-thoracotomy in a single center.

METHODS

This retrospective study assesses the survival and need for reoperation among 56 primary lung transplant recipients due to CF in a single center between 2018 and 2021. Intraoperative death was also assessed, yet it was established as an exclusion criterion for the post-transplant survival analysis.

RESULTS

Only one patient died intraoperatively (1.79%). Reoperation at an early postoperative stage was required among 2 patients (3.58%), due to vascular complication for one and pulmonary leakage for the other. Mortality at 30 days was 0%. In-hospital mortality was low (3.58%). Survival at 1, 2, and 3 years was respectively 87%, 85%, and 75%. Mean forced expiratory volume in 1 second as a percentage of predicted value at discharge was approximately 60% and did not decrease after 12 and 24 months. Mean BMI at 12-month follow-up was 20.11 (range, 13-28.7) with 71.4% of patients being qualified as presenting within the normal range of 18.5 to 24.9.

CONCLUSIONS

Double lung transplantation is a safe and feasible surgical option. Despite being more technically difficult and challenging than clamshell approach for surgeons, it is more beneficial for patients.

摘要

背景

对于因囊性纤维化 (CF) 而发展为终末期肺病的患者,肺移植仍然是他们用尽所有其他治疗选择后的最终治疗方法。本研究旨在评估单中心采用小切口进行肺移植的结果。

方法

本回顾性研究评估了 2018 年至 2021 年期间在单中心因 CF 接受 56 例原发性肺移植患者的生存和再次手术需求。还评估了术中死亡情况,但将其确立为移植后生存分析的排除标准。

结果

仅有 1 例患者(1.79%)在术中死亡。2 例患者(3.58%)在术后早期需要再次手术,其中 1 例因血管并发症,另 1 例因肺漏。30 天死亡率为 0%。住院死亡率较低(3.58%)。1、2 和 3 年生存率分别为 87%、85%和 75%。出院时预计用力呼气量的平均值为预测值的 60%左右,12 个月和 24 个月后没有下降。12 个月随访时平均 BMI 为 20.11(范围 13-28.7),71.4%的患者被评定为处于 18.5 至 24.9 的正常范围。

结论

双肺移植是一种安全可行的手术选择。尽管对于外科医生来说比蛤壳式方法更具技术难度和挑战性,但对患者更有益。

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