对于COVID-19肺移植的吸收和1年的结果
Jessica M Ruck1, Alice L Zhou1, Isabella Florissi1
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Md.
The Journal of thoracic and cardiovascular surgery
|June 7, 2023
概括
对于严重的COVID-19感染而言,肺移植 (LT) 正在增加. 虽然即时并发症较高,但COVID-19的LT后1年生存率与其他原因相似,支持其继续使用.
科学领域:
- 肺部病理学 肺部病理学
- 移植手术 移植手术
- 传染性疾病 传染性疾病
背景情况:
- 严重的COVID-19感染经常导致末期肺病,需要进行肺移植 (LT).
- 关于LT对COVID-19的结果的数据仍然有限,尽管它的流行率越来越高.
研究的目的:
- 评估肺移植 (LT) 的1年结果,特别是对于COVID-19引起的末期肺病患者.
- 为了比较COVID-19和非COVID-19LT接受者之间的移植后并发症和死亡率.
主要方法:
- 利用移植受体科学注册表来识别2020年1月至2022年10月的成年LT受体.
- 采用多变量回归来比较COVID-19和非COVID-19LT接受者之间的结果 (拒绝,呼吸机支持,气管切除术,透析,死亡率),以关键特征进行调整.
主要成果:
- 针对COVID-19的肺移植显著增加,到2021年,肺移植占整个肺移植总量的10.7%.
- COVID-19 LT接受者较年轻,更有可能是男性/西班牙裔,并且在LT前有更高的敏度 (呼吸机,ECMO,透析),但类似的1年死亡风险 (HR 0.73).
- COVID-19 LT与长时间呼吸器支持 (aOR 2.28),气管切除术 (aOR 5.3) 和更长时间住院 (27 vs 19 天) 的风险增加有关.
结论:
- 针对COVID-19的肺移植具有更高的立即术后并发症风险,但显示出可比的1年死亡率.
- 尽管COVID-19患者的移植前疾病更严重,但结果令人鼓舞.
- 这些发现支持继续利用肺移植来管理COVID-19相关的肺病.
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