Wu Shilong, Peng Guilin, Xu Chenyang, Li Xiuhua, Jiang Wenfa, Ai Qing, Yang Chao, Xiao Don, Wei Bing, Huang Weizhe, Xu Xin, He Jianxing
Department of Thoracic Surgery, Ganzhou People's Hospital, Ganzhou, China.
Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
J Thorac Dis. 2022 Apr;14(4):1020-1030. doi: 10.21037/jtd-21-1738.
Lung transplantation is a treatment for end-stage lung disease. The optimal transplant strategy for patients with end-stage lung disease complicated by pulmonary hypertension (PH) is controversial. The aim of this study is to review this experience and analyze the outcomes of lung transplantation for PH.
This retrospective study collected data on patients with PH undergoing lung transplantation between March 2016 and December 2019 at a single center in China. The perioperative features and short- and medium-term outcomes between single-lung transplantation (SLT) and double-lung transplantation (DLT) were compared. Kaplan-Meier methods were used to analyze overall survival across a variety of transplantation procedures, age, mean pulmonary artery pressure (mPAP), body mass index (BMI), and indications of transplantation.
A total of 63 patients with PH were finally included in the analysis. The mean age, mean BMI, and mPAP were 56.37 years, 19.56 kg/m, and 35.4 mmHg respectively. The overall 1-, 2-, and 3-year survival was 70%, 63%, and 60%, respectively. Five (7.94%) patients died within 30 days after surgery and nine patients (14.3%) died from infection during the followed-up period. There were no significant differences in the short- and medium-term survival outcomes of SLT and DLT, but postoperative pulmonary function was better in DLT. Patients older than 60 years of age had worse survival (P=0.01).
The short- and medium-term survival outcomes between SLT and DLT are similar in selected patients with PH. DLT provides better pulmonary function. Patients older than 60 years are associated with worse survival.
肺移植是终末期肺病的一种治疗方法。对于合并肺动脉高压（PH）的终末期肺病患者，最佳的移植策略存在争议。本研究的目的是回顾这一经验并分析PH患者肺移植的结果。
这项回顾性研究收集了2016年3月至2019年12月在中国某单一中心接受肺移植的PH患者的数据。比较了单肺移植（SLT）和双肺移植（DLT）的围手术期特征以及短期和中期结果。采用Kaplan-Meier方法分析各种移植手术、年龄、平均肺动脉压（mPAP）、体重指数（BMI）和移植指征下的总生存率。
共有63例PH患者最终纳入分析。平均年龄、平均BMI和mPAP分别为56.37岁、19.56kg/m²和35.4mmHg。总体1年、2年和3年生存率分别为70%、63%和60%。5例（7.94%）患者术后30天内死亡，9例（14.3%）患者在随访期间死于感染。SLT和DLT的短期和中期生存结果无显著差异，但DLT术后肺功能更好。年龄大于60岁的患者生存率较差（P=0.01）。
在选定的PH患者中，SLT和DLT的短期和中期生存结果相似。DLT可提供更好的肺功能。年龄大于60岁的患者生存率较差。
