Clinical analysis of 100 cases of lung transplantation for end－stage palmonary disease

Mao Wenjun(毛文君，Lung Transplant Group，Wuxi Peop Hosp，Nanjing Medi Univ，Wuxi 214023)…∥Chin J Transplant.－2011，32(8).－459 ～462

Clinical analysis of 100 cases of lung transplantation for end－stage palmonary disease

Mao Wenjun(毛文君，Lung Transplant Group，Wuxi Peop Hosp，Nanjing Medi Univ，Wuxi 214023)…∥Chin J Transplant.－2011，32(8).－459 ～462

ObjectiveTo estimate the indications，operative technique，perioperative treatment，postoperative complications and the outcome of lung transplantation(LTx)for end － stage pulmonary diseases.MethodsThe clinical data of 100 patients with end－stage lung diseases receiving LTx in our hospital were retrospectively analyzed.The main indications for LTx were as follows:idiopatic pulmonary fibrosis(IPF，47/100)，chronic obstructive pulmonary disease(COPD，33/100)，silicosis(5/100)，bronchiectasis(5/100)，Eisenmenger syndrome(4/100)，secondary lung tuberculosis(2/100)，idiopathic pulmonary hypertension(2/100)，lung lymphangioleiomyomatosis(1/100)，primary alveolar cell carcicoma(1/100).There were 72 patients receiving single LTx and 28 patients receiving bilateral LTx.Sixty－one patients received LTx under circulation support，including 5 cases of cardiopulmonary bypass(CPB)support and 56 cases of extracorporeal membrane oxygenation(ECMO)support.All the patients were followed up when they discharged from our hospital.The issues including postoperative complications and prognosis were observed.ResultsThe perioperative survival rate was 82.0%(82/100).There were 18 deaths in early stage(30 days)after LTx:10 due to pulmonary infection，6 due to primary graft dysfunction(PGD)，1 due to acute rejection(A_R)and 1 due to pulmonary infarction.The common complications included lung infection(11 cases)，PGD(10 cases)，AR(3 cases)，tracheostenosis(10 cases)，stoma fistula(3 cases)，hemorrhage(3 cases)，pulmonary embolism(3 cases)，pulmonary artery stenosis(one case)and thrombus in the deep veins of lower limb(one case).During long－term follow －up period，15 patients developed obliterative bronchiolitis，and one patient suffered from lung cancer in his contralateral native lung.The 1－，2－，3－ and 5－year survival rate after LTx was 73.3%，61.6%，53.5%and 40.7%respectively.ConclusionLTx is an effective therapy for various end－stage pulmonary diseases.Perioperative mortality is especially high in patients undergoing LTK consummate perioperative management is the key to increase survival rate.12 refs，1 fig.

(Authors)