由于美国的COVID-19导致的呼吸衰竭,肺移植的模式正在发生变化
Kemarut Laothamatas1, Luke Benvenuto2, Frank D'Ovidio3
1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York.
概括
肺移植成为严重的COVID-19呼吸衰竭的关键治疗方法. 虽然最初用于急性痛苦,但现在越来越多地帮助肺纤维化幸存者,一年死亡率为13.7%.
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经常导致急性呼吸系统应急综合征 (ARDS),导致幸存者的死亡率和长期肺部问题.
- 持续的间歇性肺异常影响高达31%的COVID-19幸存者,影响肺功能和生活质量.
- 到2020年中期,肺移植成为COVID-19患者呼吸衰竭的拯救生命的选择.
研究的目的:
- 分析美国COVID-19肺移植的趋势和结果.
- 为了确定COVID-19后肺移植患者选择的变化.
- 报告与此程序相关的早期移植后死亡率.
主要方法:
- 在2020年3月至2022年12月期间,美国对477例COVID-19肺移植进行了回顾性分析.
- 检查疫情期间患者等待名单和移植趋势.
- 移植后的一年死亡率的评估.
主要成果:
- 观察到COVID-19肺移植的稳步增加,在2021年底达到顶峰,随后下降.
- 发现了明显的指示转变,现在对COVID-19相关的肺纤维化进行的手术比对耐火性ARDS进行的手术更多.
- 移植后的一年死亡率为13.7%.
结论:
- 肺移植一直是严重的COVID-19呼吸衰竭的重要干预措施.
- 患者选择标准已经进化,有利于肺纤维化而不是急性ARDS.
- 对于COVID-19的肺移植具有相当大的但可管理的早期死亡风险.
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