Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
Department of Cardiothoracic Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, 363000, China.
Front Med. 2022 Oct;16(5):760-765. doi: 10.1007/s11684-021-0899-5. Epub 2022 Jul 1.
Voluntary contribution has become the only source of donor lungs in China since 2015. To elaborate the outcomes of patients awaiting lung transplantation (LTx) after the implementation of donation after brain death, we performed a retrospective study that encompassed 205 patients with end-stage lung disease who registered for LTx at Shanghai Pulmonary Hospital from January 1, 2015 to January 1, 2021. A total of 180 patients were enrolled in the study. The median waiting time was 1.25 months. Interstitial lung disease (ILD) (103/180, 57.2%) and chronic obstructive pulmonary disease (COPD) (56/180, 31.1%) were the most common diseases in our study population. The mean pulmonary artery pressure (mPAP) of patients in the died-waiting group was higher than that of the survivors (53.29±21.71 mmHg vs. 42.11±18.58 mmHg, P=0.002). The mortality of patients with ILD (34/103, 33.00%) was nearly twice that of patients with COPD (10/56, 17.86%) while awaiting LTx (P=0.041). In the died-waiting group, patients with ILD had a shorter median waiting time than patients with COPD after being listed (0.865 months vs. 4.720 months, P=0.030). ILD as primary disease and mPAP > 35 mmHg were two significant independent risk factors for waitlist mortality, with hazard ratios (HR) of 3.483 (95% CI 1.311-9.111; P=0.011) and 3.500 (95% CI 1.435-8.536; P=0.006). Hence, LTx is more urgently needed in patients with ILD and pulmonary hypertension.
自 2015 年以来，自愿捐献已成为中国供体肺的唯一来源。为了详细阐述脑死亡后器官捐献实施后等待肺移植（LTx）患者的结局，我们进行了一项回顾性研究，纳入了 2015 年 1 月 1 日至 2021 年 1 月 1 日期间在上海肺科医院登记接受 LTx 的 205 例终末期肺病患者。共有 180 例患者纳入研究。中位等待时间为 1.25 个月。间质性肺疾病（ILD）（103/180，57.2%）和慢性阻塞性肺疾病（COPD）（56/180，31.1%）是本研究人群中最常见的疾病。死亡等待组患者的平均肺动脉压（mPAP）高于幸存者（53.29±21.71mmHg 比 42.11±18.58mmHg，P=0.002）。ILD 患者（34/103，33.00%）的死亡率几乎是 COPD 患者（10/56，17.86%）的两倍，而等待 LTx 时（P=0.041）。在死亡等待组中，ILD 患者在被列入名单后等待时间中位数比 COPD 患者更短（0.865 个月比 4.720 个月，P=0.030）。原发性疾病为 ILD 和 mPAP＞35mmHg 是等待名单死亡率的两个显著独立危险因素，危险比（HR）分别为 3.483（95%可信区间 1.311-9.111；P=0.011）和 3.500（95%可信区间 1.435-8.536；P=0.006）。因此，ILD 和肺动脉高压患者更需要 LTx。
