Restrictive allograft dysfunction rather than bronchiolitis obliterans syndrome had a major impact on the overall survival after living-donor lobar lung transplantation

被引:1
|
作者
Matsubara, Kei [1 ]
Otani, Shinji [1 ,2 ]
Yamamoto, Haruchika [1 ,3 ]
Hashimoto, Kohei [1 ]
Tanaka, Shin [1 ]
Shien, Kazuhiko [1 ]
Suzawa, Ken [1 ]
Miyoshi, Kentaroh [1 ]
Yamamoto, Hiromasa [1 ]
Okazaki, Mikio [1 ]
Sugimoto, Seiichiro [1 ]
Toyooka, Shinichi [1 ]
机构
[1] Okayama Univ Grad Sch Med, Dept Gen Thorac Surg & Breast & Endocrinol Surg De, 2-5-1 Shikata Cho,Kita Ku, Okayama 7008558, Japan
[2] Ehime Univ Hosp, Dept Cardiovasc & Thorac Surg, 454 Shitsukawa, Toon, Ehime 7910295, Japan
[3] Univ Hlth Network, Toronto Gen Hosp Res Inst, Latner Thorac Surg Res Labs, Toronto, ON, Canada
关键词
Lung transplantation; Chronic lung allograft dysfunction; Bronchiolitis obliterans syndrome; Restrictive allograft syndrome; Living-donor lobar lung transplantation;
D O I
10.1007/s00595-023-02729-2
中图分类号
R61 [外科手术学];
学科分类号
摘要
PurposeChronic lung allograft dysfunction (CLAD) is a known long-term fatal disorder after lung transplantation. In this study, we evaluated the CLAD classification of the International Society for Heart and Lung Transplantation (ISHLT) for living-donor lobar lung transplantation (LDLLT).MethodsWe conducted a single-center retrospective review of data from 73 patients who underwent bilateral LDLLT between 1998 and 2019. Factors related to opacity on computed tomography (CT) and restriction on pulmonary function tests (PFTs) were also analyzed.ResultsOverall, 26 (36%) patients were diagnosed with CLAD, including restrictive allograft syndrome (RAS), n = 10 (38.5%); bronchiolitis obliterans syndrome (BOS), n = 8 (30.8%); mixed, n = 1 (3.8%); undefined, n = 2 (7.7%); and unclassified, n = 5 (19.2%). The 5-year survival rate after the CLAD onset was 60.7%. The survival of patients with BOS was significantly better than that of patients with RAS (p = 0.012). In particular, patients with restriction on PFT had a significantly worse survival than those without restriction (p = 0.001).ConclusionsCLAD after bilateral LDLLT does not have a major impact on the recipient survival, especially in patients with BOS. Restriction on PFT may predict a particularly poor prognosis in patients with CLAD after bilateral LDLLT.
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收藏
页码:317 / 324
页数:8
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