王净, 胡春兰, 于慧智, 等. 供者年龄对特发性肺纤维化患者肺移植术后短期生存结局的影响[J]. 器官移植, 2023, 14(3): 420-426. DOI: 10.3969/j.issn.1674-7445.2023.03.014
引用本文: 王净, 胡春兰, 于慧智, 等. 供者年龄对特发性肺纤维化患者肺移植术后短期生存结局的影响[J]. 器官移植, 2023, 14(3): 420-426. DOI: 10.3969/j.issn.1674-7445.2023.03.014
Wang Jing, Hu Chunlan, Yu Huizhi, et al. Effect of donor age on short-term survival of patients with idiopathic pulmonary fibrosis after lung transplantation[J]. ORGAN TRANSPLANTATION, 2023, 14(3): 420-426. DOI: 10.3969/j.issn.1674-7445.2023.03.014
Citation: Wang Jing, Hu Chunlan, Yu Huizhi, et al. Effect of donor age on short-term survival of patients with idiopathic pulmonary fibrosis after lung transplantation[J]. ORGAN TRANSPLANTATION, 2023, 14(3): 420-426. DOI: 10.3969/j.issn.1674-7445.2023.03.014

供者年龄对特发性肺纤维化患者肺移植术后短期生存结局的影响

Effect of donor age on short-term survival of patients with idiopathic pulmonary fibrosis after lung transplantation

  • 摘要:
      目的  探讨供者年龄对特发性肺纤维化(IPF)患者肺移植术后短期生存结局的影响。
      方法  回顾性分析235例IPF肺移植供、受者的临床资料。使用单因素和多因素Cox比例风险回归模型分析供者年龄与IPF患者肺移植术后短期死亡风险的关系,采用Kaplan-Meier法绘制生存曲线。
      结果  单因素Cox回归分析结果显示,供者年龄与IPF患者肺移植术后1年病死率相关,供者年龄每增加1岁,受者术后1年死亡风险增加0.020倍(P=0.009)。供者氧合指数,受者术前氧合指数、术前肺源分配评分、术前氨基末端脑钠肽前体、移植方式、术中体外膜氧合方式和术中输血量与肺移植术后1年病死率存在相关性(均为P < 0.1)。多因素Cox回归分析显示,供者年龄与IPF患者肺移植术后30、90、180 d和1年的死亡风险无相关性(均为P > 0.05)。敏感性分析发现供者年龄 < 18岁、18~33岁、34~49岁、≥50岁的肺移植受者术后30、90、180 d和1年死亡风险差异均无统计学意义(均为P > 0.05)。
      结论  本研究未观察到供者年龄对IPF患者肺移植术后短期生存存在影响,综合考虑供者机械通气时间、氧合指数、感染等因素后,可考虑扩大肺移植供者年龄范围。

     

    Abstract:
      Objective  To evaluate the effect of donor age on short-term survival of patients with idiopathic pulmonary fibrosis (IPF) after lung transplantation.
      Methods  Clinical data of 235 IPF donors and recipients of lung transplantation were retrospectively analyzed. Univariate and multivariate Cox proportional hazard regression models were employed to analyze the correlation between donor age and short-term mortality rate of IPF patients after lung transplantation. Kaplan-Meier was used to draw the survival curve.
      Results  Univariate Cox regression analysis showed that donor age was correlated with the 1-year fatality of IPF patients after lung transplantation. The 1-year fatality of recipients after lung transplantation was increased by 0.020 times if donor age was increased by 1 year (P=0.009). Oxygenation index of the donors, preoperative oxygenation index, preoperative lung allocation score, preoperative N-terminal pro brain natriuretic peptide, pattern of transplantation, pattern of intraoperative extracorporeal membrane oxygenation and intraoperative blood transfusion volume of the recipients were correlated with 1-year fatality after lung transplantation (all P < 0.1). Multivariate Cox regression analysis demonstrated that there was no correlation between donor age and 30-, 90-, 180-d and 1-year fatality of IPF patients after lung transplantation (all P > 0.05). Sensitivity analysis showed that there was no significant difference in 30-, 90-, 180-d and 1-year fatality after lung transplantation among donors aged < 18, 18-33, 34-49 and ≥50 years (all P > 0.05).
      Conclusions  Donor age exerts no effect upon short-term survival of IPF patients after lung transplantation. Considering the mechanical ventilation time, oxygenation index, infection and other factors of donors, the age range of lung transplant donors may be expanded.

     

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