Lungeavdelingen, Oslo universitetssykehus, Rikshospitalet.
Lungeavdelingen, Oslo universitetssykehus, Rikshospitalet, og, Institutt for klinisk medisin, Universitetet i Oslo.
Tidsskr Nor Laegeforen. 2023 Sep 27;143(14). doi: 10.4045/tidsskr.22.0775. Print 2023 Oct 10.
Since 2009, patients with a rapidly progressing lung disease have been given a higher priority on the waiting list for a lung transplant. The purpose of our study was to examine diagnosis distribution, waiting list times, mortality and survival for patients on the waiting list in the period 1999-2020.
We conducted a descriptive, retrospective study of patients on the waiting list for a lung transplant in the periods 1999-2008 and 2009-2020.
A total of 557 lung transplants were performed: 185 in 1999-2008 (median of 17.5 per year) and 372 in 2009-2020 (median of 32.5 per year). In the periods 1999-2008 and 2009-2020, the proportion of patients with chronic obstructive pulmonary disease (COPD)/emphysema was 67 % and 49 %, respectively. The corresponding figures for pulmonary fibrosis were 13 % and 23 %, and for cystic fibrosis 5 % and 11 %. Waiting list mortality was 27 % in 1999-2008 and 16 % in 2009-2020. Correspondingly for the two periods, waiting list mortality for patients with pulmonary fibrosis was 45 % and 22 %, and for cystic fibrosis 41 % and 2 %. Waiting times were shorter for all diagnoses in the period after the change in priority and longest for patients with COPD/emphysema (median of 381 days). Median survival after lung transplantation during the study period was ten years.
For patients with pulmonary fibrosis and cystic fibrosis, the change in transplant priority in 2009 may have played a role in reducing waiting list mortality.
自 2009 年以来，患有快速进展性肺病的患者在肺移植等待名单上的优先级更高。我们的研究目的是检查 1999 年至 2020 年期间等待名单上患者的诊断分布、等待时间、死亡率和生存率。
我们对 1999 年至 2008 年和 2009 年至 2020 年期间等待肺移植的患者进行了描述性、回顾性研究。
共进行了 557 例肺移植：1999-2008 年 185 例（中位数为每年 17.5 例），2009-2020 年 372 例（中位数为每年 32.5 例）。在 1999-2008 年和 2009-2020 年期间，慢性阻塞性肺疾病（COPD）/肺气肿患者的比例分别为 67%和 49%。相应的肺纤维化比例分别为 13%和 23%，囊性纤维化比例分别为 5%和 11%。1999-2008 年等待名单死亡率为 27%，2009-2020 年为 16%。相应地，对于这两个时期，肺纤维化患者的等待名单死亡率分别为 45%和 22%，囊性纤维化患者的死亡率分别为 41%和 2%。在优先级更改后的时期，所有诊断的等待时间都缩短了，而 COPD/肺气肿患者的等待时间最长（中位数为 381 天）。研究期间肺移植后的中位生存时间为十年。
对于肺纤维化和囊性纤维化患者，2009 年移植优先级的改变可能在降低等待名单死亡率方面发挥了作用。
