Park S J, Houck J, Pifarre R, Sullivan H, Garrity E, Kim S Y, Zbilut J, Montoya A
Department of Thoracic and Cardiovascular Surgery, Loyola University Medical Center, Maywood, Ill 60153, USA.
J Heart Lung Transplant. 1995 Jul-Aug;14(4):671-5.
Single lung transplantation for patients with end-stage obstructive lung disease has been highly effective in providing symptomatic relief, and it has been performed at a much increased frequency since 1983. However, there still lacks a convincing study showing the effect of size match and other preoperative variables in predicting functional outcome of patients after transplantation.
We evaluated 23 single lung transplantations performed for obstructive lung disease over a 34-month period. Multiple physiologic variables and size match criteria were evaluated for their contribution in determining the postoperative forced expiratory volume in 1 second at 3 months after transplantation.
The size match ratio that was based on inframammary chest wall circumference was the most useful criterion to adopt, and the optimal donor/recipient size match ratio was 0.89. Furthermore, forced expiratory volume in 1 second at 3 months after transplantation could be predicted with a simple mathematical model that was based on the size match ratio and the recipient's calculated vital capacity of the transplanted hemithorax.
This model could be applied in a clinical setting to maximize functional outcome of the recipients undergoing single lung transplantation.
对于终末期阻塞性肺疾病患者，单肺移植在缓解症状方面非常有效，自1983年以来其实施频率大幅增加。然而，仍缺乏有说服力的研究来表明大小匹配及其他术前变量对预测移植后患者功能结局的影响。
我们评估了在34个月期间为阻塞性肺疾病实施的23例单肺移植手术。评估了多个生理变量和大小匹配标准对确定移植后3个月时1秒用力呼气量的作用。
基于乳房下胸壁周长的大小匹配比是最有用的标准，最佳供体/受体大小匹配比为0.89。此外，移植后3个月时的1秒用力呼气量可以通过一个基于大小匹配比和受体计算出的移植半侧胸廓肺活量的简单数学模型来预测。
该模型可应用于临床环境，以使接受单肺移植的受体功能结局最大化。
