Fujii Kento, Tanaka Shin, Ishihara Megumi, Matsubara Kei, Hashimoto Kohei, Okahara Shuji, Shien Kazuhiko, Suzawa Ken, Miyoshi Kentaroh, Otani Shinji, Yamamoto Hiromasa, Okazaki Mikio, Sugimoto Seiichiro, Yamane Masaomi, Toyooka Shinichi
Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital, Okayama, Japan.
Department of Anesthesiology and Resuscitology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
Clin Transplant. 2023 Apr;37(4):e14927. doi: 10.1111/ctr.14927. Epub 2023 Feb 17.
Living-donor lobar lung transplantation is an alternative procedure to deceased donation lung transplantation. It involves graft donation from healthy donors; however, only a few reports have discussed its long-term prognosis in living lung donors and their associated health-related quality of life. This study aimed to examine living lung donors' health-related quality of life.
In our cross-sectional survey of living lung donors, we assessed health-related quality of life-based on three key aspects (physical, mental, and social health) using the 36-Item Short Form Health Survey. We also evaluated chronic postoperative pain and postoperative breathlessness using the numeric rating scale and the modified Medical Research Council Dyspnea scale, respectively.
We obtained consent from 117 of 174 living lung donors. The average scores of the living lung donors on the 36-Item Short Form Health Survey were higher than the national average. However, some donors had poorer physical, mental, and social health, with lower summary scores than the national averages. Low mental component summary predictors included donor age (<40 years; odds ratio = 10.2; p < .001) and recipient age (<18 years; odds ratio = 2.73; p < .032). Low role-social component summary predictors included high lung allocation score (≥50; odds ratio = 3.94, p < .002) and recipient death (odds ratio = 3.64; p = .005). There were no predictors for a physical component summary. Additionally, many donors did not complain of pain or dyspnea.
Living lung donors maintained an acceptable long-term health-related quality of life after surgery. Potential donors should be informed of relevant risk factors, and high-risk donors should receive appropriate support.
活体供者肺叶移植是尸体供者肺移植的一种替代手术。它涉及从健康供者获取移植物；然而，仅有少数报告讨论了活体肺供者的长期预后及其相关的健康相关生活质量。本研究旨在探讨活体肺供者的健康相关生活质量。
在我们对活体肺供者的横断面调查中，我们使用36项简明健康调查问卷，基于三个关键方面（身体、心理和社会健康）评估健康相关生活质量。我们还分别使用数字评分量表和改良的医学研究理事会呼吸困难量表评估慢性术后疼痛和术后呼吸困难。
我们获得了174名活体肺供者中117名的同意。活体肺供者在36项简明健康调查问卷上的平均得分高于全国平均水平。然而，一些供者的身体、心理和社会健康状况较差，其总结得分低于全国平均水平。低心理成分总结预测因素包括供者年龄（<40岁；比值比=10.2；p<.001）和受者年龄（<18岁；比值比=2.73；p<.032）。低角色-社会成分总结预测因素包括高肺分配评分（≥50；比值比=3.94，p<.002）和受者死亡（比值比=3.64；p=.005）。没有身体成分总结的预测因素。此外，许多供者没有诉说疼痛或呼吸困难。
活体肺供者术后维持了可接受的长期健康相关生活质量。应告知潜在供者相关风险因素，高危供者应获得适当支持。
