候选人肺移植候选人的等待名单死亡率和潜在风险因素:一个单一数据中心数据中心
Ertan Sarıbaş1, Ayse Nigar Halis1, Sevinc Citak2
1Department of Pulmonology, Kartal Kosuyolu High Specialization Education & Research Hospital, Istanbul, Türkiye.
Transplantation proceedings
|October 23, 2025
概括
供体肺稀缺导致肺移植候选人的等待时间长,死亡率高. 关键的风险因素,如主要异常间歇性肺炎和血管疾病的影响生存率,指导更好的患者管理.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 移植手术 移植手术
背景情况:
- 肺移植是末期肺病的关键治疗方法.
- 由于供体肺的可用性有限,造成了大量的等待列表.
- 在等待名单上的患者的结果需要仔细评估.
研究的目的:
- 评估等待肺移植的患者的生存时间.
- 确定肺移植候选人的死亡风险因素.
- 分析单一中心等候名单死亡率.
主要方法:
- 对202名肺移植患者的回顾性分析 (2017年1月至2023年5月).
- 分类为诊断组:阻塞性,血管性,补充性,主要异常性间歇性肺炎 (IIP) 和其他.
- 使用卡普兰-梅尔曲线和考克斯回归来确定危险因素的生存分析.
主要成果:
- 总的等待名单死亡率为34.7%,主要IIP患者的死亡率最高 (47.7%).
- 死亡率预测因素包括身高较低,主要IIP/血管疾病诊断,肺动脉静脉压升高 (PAPs),TAPSE/PAPs比率较低,以及高肺血管阻力 (PVR).
- PAP≥52mmHg增加了3.99倍的死亡风险;血管疾病患者的存活时间最短 (15.6个月).
结论:
- 供体器官短缺显著影响肺移植等待时间和患者死亡率.
- 识别死亡风险,特别是在主要的IIP和血管疾病中,至关重要.
- 优化列表策略和临床管理可以改善肺移植候选人的结果.
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