Current Situation and Prognostic Evolution of Combined Heart-lung Transplantation in a European Union Country.

IF 0.3 Q4 TRANSPLANTATION

International Journal of Organ Transplantation Medicine Pub Date : 2022-01-01

R Lopez-Vilella, M Gomez Bueno, F Gonzalez Vflchez, A Sole Jover, R Laporta Hernandez, R Vicente Guillen, A I Gonzalez Roman, I Sanchez-Lazaro, F Hernandez Perez, G Sales Badfa, M D M Cordoba Pelaez, S Torregrosa Puerta, A Forteza Gil, L Martinez Dolz, J Segovia Cubero, L Almenar Bonet

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引用次数: 0

Abstract

Background: This study aims to evaluate the entire experience in heart-lung transplantation (HLTx) in a country of the European Union with 47 million inhabitants according to the etiologies that motivated the procedure.

Methods: A retrospective study on 1,751 consecutive transplants (HLTx: 78) was performed from 1990 to 2020 in two centers. Overall survival, adjusted for clinical profile and etiological subgroups, was compared. 7 subgroups were considered: 1) Cardiomyopathy with pulmonary hypertension (CM + PH). 2) Eisenmenger syndrome. 3) Congenital heart disease (CHD). 4) Idiopathic pulmonary arterial hypertension (IPAH). 5) Cystic fibrosis. 6) Chronic obstructive pulmonary disease (COPD)/Emphysema. 7) Diffuse interstitial lung disease (ILD).

Results: Early mortality was 44% and that of the rest of the follow-up was 31%. There were differences between HTLx and HTx in survival, also comparing groups with a similar clinical profile with propensity score (p= 0.04). Median survival was low in CM + PH (18 days), ILD (29 days) and CHD (114 days), intermediate in Eisenmenger syndrome (600 days), and longer in IPAH, COPD/Emphysema and cystic fibrosis.

Conclusion: HLTx has a high mortality. The etiological analysis is of the utmost interest to make the most of the organs and improve survival.

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欧盟国家联合心肺移植的现状及预后演变。

背景:本研究旨在评估一个拥有4700万居民的欧盟国家的心肺移植(HLTx)的整体经验，根据动机的病因进行手术。方法:回顾性研究1990年至2020年在两个中心进行的1,751例连续移植手术(HLTx: 78)。根据临床情况和病因亚组进行调整后的总生存率比较。分为7个亚组:1)心肌病合并肺动脉高压(CM + PH)。2)艾森曼格综合症。3)先天性心脏病(CHD)。4)特发性肺动脉高压(IPAH)。5)囊性纤维化。6)慢性阻塞性肺病(COPD)/肺气肿。7)弥漫性间质性肺疾病。结果:早期死亡率为44%，其余随访期死亡率为31%。HTLx组和HTx组的生存率存在差异，临床特征相似组的倾向评分也存在差异(p= 0.04)。CM + PH(18天)、ILD(29天)和CHD(114天)的中位生存期较低，艾森曼格综合征(600天)的中位生存期中等，IPAH、COPD/肺气肿和囊性纤维化的中位生存期较长。结论:HLTx病死率高。病因分析是最大的兴趣，使器官和提高生存率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Organ Transplantation Medicine TRANSPLANTATION-

CiteScore

1.60

自引率

0.00%

发文量

审稿时长

12 weeks

期刊介绍： The International Journal of Organ Transplantation Medicine (IJOTM) is a quarterly peer-reviewed English-language journal that publishes high-quality basic sciences and clinical research on transplantation. The scope of the journal includes organ and tissue donation, procurement and preservation; surgical techniques, innovations, and novelties in all aspects of transplantation; genomics and immunobiology; immunosuppressive drugs and pharmacology relevant to transplantation; graft survival and prevention of graft dysfunction and failure; clinical trials and population analyses in the field of transplantation; transplant complications; cell and tissue transplantation; infection; post-transplant malignancies; sociological and ethical issues and xenotransplantation.