土耳其尸体大叶肺移植的初步经验

M. Vayvada, A. Erkılınç
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摘要

肺移植是终末期肺部疾病的最后治疗选择。供体短缺是等待名单死亡的主要原因。大叶肺移植已被提出以克服供体短缺。在此,我们介绍了我们对接受大叶肺移植的患者的初步经验。患者和方法:这项单中心回顾性研究纳入了2016年12月至2018年12月在肺移植中心接受尸体大叶肺移植的患者。该手术仅对处于紧急状态的患者实施。结果:研究期间55例肺移植中,6例[10.9%;四女两男;中位年龄为35.3岁(范围22-42岁)。适应症为支气管扩张(3例)、慢性阻塞性肺疾病(1例)、囊性肺疾病(1例)、鳞状腺癌(1例)。2例为双侧大叶肺移植,2例为右单肺+左下肺叶移植,2例为左单肺+右下肺叶移植。1年死亡率为16.6%(1/6)。2例患者在肺移植术后23个月和24个月死亡。最后一次随访时(24、25、47个月)有3例患者存活。结论:大叶肺移植是解决胸腔狭窄危重患者供体不足的一种治疗方法。此外,对于单侧胸腔缩小的受术者,这是一种可行的手术技术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Initial Experience with Cadaveric Lobar Lung Transplantation in Turkey
Introduction: Lung transplantation is the final treatment option for end-stage lung diseases. A scarce donor pool is the primary cause of waiting list mortality. Lobar lung transplantation has been proposed to overcome the donor pool shortage. Herein we present our initial experience with patients who underwent lobar lung transplantation. Patients and Methods: This single-center retrospective study included patients who underwent cadaveric lobar lung transplantation between December 2016 and December 2018 at our Lung Transplant Center. The procedure was performed only in patients with an emergency status. Results: Of the 55 lung transplants during the study period, six [10.9%; four female, two male; median age, 35.3 years (range, 22-42 years)] were lobar lung transplants. The indications were bronchiectasis (three patients), chronic obstructive pulmonary disease (one patient), cystic lung disease (one patient), and lepidic type adenocarcinoma (one patient). The transplantations included bilateral lobar lung in two patients, the right single lung and the left lower lobe in two patients, and the left single lung and the right lower lobe in two patients. One-year mortality was 16.6% (1/6). Two patients died 23 and 24 months after lung transplantation. Three patients were alive at the last follow-up (at 24, 25, 47 months). Conclusion: Lobar lung transplantation can be a life-saving treatment option in critically ill patients with small thoracic cavities to overcome donor shortage. Furthermore, it is a feasible operative technique in recipients with a reduced unilateral thoracic cavity.
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