捐赠者吸烟对初级移植功能障碍和肺移植后死亡率的影响
Joshua M Diamond1, Edward Cantu2, Carolyn S Calfee3
1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine.
American journal of respiratory and critical care medicine
|September 21, 2023
概括
捐赠者吸烟稍微增加了肺移植后初级移植功能障碍的风险,但不会影响接受者的生存率. 吸烟者的肺似乎是安全的,可能会增加捐赠者的可用性.
科学领域:
- 移植免疫学 移植免疫学
- 肺部医学 肺部医学
- 毒理学 毒理学 毒理学
背景情况:
- 主要移植功能障碍 (PGD) 是肺移植后发病率和死亡率的主要原因.
- 以前的研究表明,供体吸烟是PGD和死亡率的风险因素.
研究的目的:
- 量化捐赠者烟雾暴露对PGD和死亡率的影响.
- 利用定量生物标志物来更准确地评估供体吸烟的影响.
主要方法:
- 一个多中心前性队列研究,涉及肺移植接受者 (2012-2018).
- PGD定义为3级在转血后48/72小时后.
- 通过尿路丁胺和NNAL生物标志物评估的捐赠者吸烟,以及临床病史.
主要成果:
- 活体供体吸烟的患病率各不相同 (34-43%是科提宁,28%是NNAL,37%是临床).
- 捐赠者吸烟显示,在所有定义中,PGD风险的增加是适度的,但是一致的.
- 在捐赠者吸烟和移植后接受者存活率之间没有发现显著的关联.
结论:
- 捐赠者吸烟与PGD风险的小幅增加有关,但与接受者死亡率无关.
- 利用吸烟者的肺部可能是安全的,并可以扩大捐赠池.
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