在之前的心脏外科手术后进行肺移植
Shane S Scott1,2, Doug A Gouchoe1, Divyaam Satija1
1Department of Surgery, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
JHLT open
|March 27, 2025
概括
以前接受过心脏手术的肺移植患者,包括冠状动脉旁路移植 (CABG) 和门手术,生存率降低,但并没有被禁止移植. 建议对CABG患者进行血管疾病的仔细评估,以改善结果.
科学领域:
- 心脏病学 心脏病学
- 胸部外科手术 胸部外科手术
- 移植医学 移植医学
背景情况:
- 肺移植候选人年龄越来越大,并患有更多的并发病.
- 前期心脏手术是肺移植候选人的日益关注的问题.
- 检查之前心脏手术的患者的肺移植后的结果至关重要.
研究的目的:
- 为了确定肺移植接受者之前心脏手术的患病率.
- 为了比较之前心脏手术和没有心脏手术的肺移植患者的结果.
- 为了确定影响肺移植接受者与心脏手术的历史生存的因素.
主要方法:
- 利用了美国器官共享网络/器官采购和移植网络数据库.
- 将患者分层分为没有手术,先前冠状动脉旁路移植 (CABG) 和先前门手术组.
- 使用Kaplan-Meier方法进行调整后生存时间比较的就业倾向匹配.
主要成果:
- 确定了28,710名肺移植接受者;1.6%之前进行过CABG,0.3%之前进行过门手术.
- 之前接受CABG的患者的5年生存率比没有手术的患者低 (p < 0.01).
- 在没有手术和之前的门手术组之间没有观察到显著的生存差异 (p = 0.4).
结论:
- 接受过CABG或门手术的肺移植患者的生存率下降.
- 结果并不严厉,表明移植仍然是一个可行的选择.
- 在CABG患者的血管疾病负担的移植前评估对于优化移植后生存至关重要.
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