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ILD 诊断至转诊至移植中心的时间对纳入移植等待名单的概率的影响。

The impact of time from ILD diagnosis to referral to the transplant center on the probability of inclusion in the transplant waiting list.

机构信息

Respiratory Department, Lung Transplant Unit, ERN-LUNG (European Reference Network on Rare Respiratory Diseases), Marqués de Valdecilla University Hospital, Avda. Valdecilla s/n. 39008, Santander, Spain.

Respiratory Department. ERN-LUNG (European Reference Network on Rare Respiratory Diseases), Marqués de Valdecilla University Hospital, Spain.

出版信息

Heart Lung. 2024 Sep-Oct;67:92-99. doi: 10.1016/j.hrtlng.2024.04.022. Epub 2024 May 11.

Abstract

BACKGROUND

Lung transplant is a therapeutic option for patients with progressive interstitial lung disease (ILD).

OBJECTIVES

The objective of this study was to determine whether time from ILD diagnosis to referral to a transplant center influences the probability of being included in the transplant waiting list.

METHODS

We performed a retrospective cohort study including all ILD patients evaluated as lung transplantation (LT) candidates at a lung transplant center between 01/01/2017 and 31/12/2022. The primary endpoint was the probability of being included in the lung transplant waiting list according to the time elapsed from diagnosis to referral to the transplant center.

RESULTS

A total of 843 lung transplant requests were received, of which 367 (43.5%) were associated with ILD. Thirteen patients were excluded because they did not attend the first visit, whereas another 11 were excluded because some information was missing. As a result, our final sample was composed of 343 patients. The median time from diagnosis to referral was 29.4 (10.9 - 61.1) months. The overall probability of inclusion in the waiting list was 29.7%. By time from diagnosis to referral, the probability of inclusion in the waiting list was 48.1% for the patients referred 〈 6 months from diagnosis; 27.5% for patients referred 6 to 24 months from diagnosis; and 25.8% for patients referred 〉 24 months from diagnosis (p = 0.007).

CONCLUSIONS

Early referral to a lung transplant center seemed to increase the probability of being included in the lung transplant waiting list. Further research is needed in this topic.

摘要

背景

肺移植是治疗进行性间质性肺疾病(ILD)患者的一种治疗选择。

目的

本研究旨在确定从ILD 诊断到转诊到移植中心的时间是否会影响被纳入移植等待名单的概率。

方法

我们进行了一项回顾性队列研究,纳入了 2017 年 1 月 1 日至 2022 年 12 月 31 日期间在肺移植中心评估为肺移植(LT)候选者的所有ILD 患者。主要终点是根据从诊断到转诊到移植中心的时间,被纳入肺移植等待名单的概率。

结果

共收到 843 份肺移植请求,其中 367 份(43.5%)与ILD 相关。由于 13 名患者未参加首次就诊,另外 11 名患者由于某些信息缺失而被排除在外。因此,我们的最终样本由 343 名患者组成。从诊断到转诊的中位时间为 29.4(10.9-61.1)个月。总体纳入等待名单的概率为 29.7%。按从诊断到转诊的时间,从诊断到转诊〈6 个月的患者纳入等待名单的概率为 48.1%;从诊断到转诊 6-24 个月的患者为 27.5%;从诊断到转诊〉24 个月的患者为 25.8%(p = 0.007)。

结论

早期转诊到肺移植中心似乎增加了被纳入肺移植等待名单的概率。在这个话题上需要进一步的研究。

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