Emergency Medical Center, Ningbo Yinzhou No. 2 Hospital, Ningbo, Zhejiang, China.
The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Ann Thorac Cardiovasc Surg. 2024;30(1). doi: 10.5761/atcs.ra.24-00086.
This meta-analysis aimed to examine the prognosis of patients with acute exacerbation of interstitial lung disease (AE-ILD) treated with lung transplantation compared to those with stable interstitial lung disease (ILD).
We conducted a detailed search in PubMed, Embase, Web of Science, and the Cochrane Library, with the primary outcomes being overall survival (OS), acute cellular rejection (ACR), primary graft dysfunction (PGD), and length of stay (LOS).
Five cohort studies were included in this meta-analysis, with 183 patients enrolled in the AE-ILD group and 337 patients in the stable-ILD group. The results showed that in regard to perioperative outcomes, the AE-ILD group did not differ from the stable-ILD group in the incidence of ACR (relative risks [RR] = 0.34, p = 0.44) and the incidence of PGD Ⅲ (RR = 0.53, p = 0.43), but had a longer LOS (mean difference = 9.15, p = 0.02). Regarding prognosis, the two also did not differ in 90-day OS (RR = 0.97, p = 0.59), 1-year OS (RR = 1.05, p = 0.66), and 3-year OS (RR = 0.91, p = 0.76).
Our study concluded that the efficacy of lung transplantation in patients with AE-ILD is not inferior to that of patients with stable ILD. Lung transplantation is one of the potential treatments for patients with AE-ILD.
本荟萃分析旨在比较急性加重期间质性肺疾病（AE-ILD）患者与稳定期间质性肺疾病（ILD）患者接受肺移植的预后。
我们在 PubMed、Embase、Web of Science 和 Cochrane Library 中进行了详细的检索，主要结局是总生存率（OS）、急性细胞排斥（ACR）、原发性移植物功能障碍（PGD）和住院时间（LOS）。
本荟萃分析纳入了 5 项队列研究，AE-ILD 组纳入 183 例患者，稳定-ILD 组纳入 337 例患者。结果显示，在围手术期结局方面，AE-ILD 组与稳定-ILD 组在 ACR 发生率（相对风险 [RR] = 0.34，p = 0.44）和 PGD Ⅲ发生率（RR = 0.53，p = 0.43）方面无差异，但 LOS 较长（平均差异=9.15，p = 0.02）。在预后方面，两组 90 天 OS（RR = 0.97，p = 0.59）、1 年 OS（RR = 1.05，p = 0.66）和 3 年 OS（RR = 0.91，p = 0.76）也无差异。
本研究表明，AE-ILD 患者肺移植的疗效并不逊于稳定期 ILD 患者。肺移植是 AE-ILD 患者的潜在治疗方法之一。
