紧急肺移植的临床应用进展

Progress in clinical application of urgent lung transplantation

  • 摘要: 肺移植是终末期肺病唯一有效的治疗手段,然而世界范围内供肺紧缺的问题日益突出,许多患者在等待移植的过程中死亡。紧急肺移植是一种根据患者疾病紧急程度进行优先移植的肺源分配策略,其目的是为了减少肺源等待时间和降低肺移植等待者的病死率。然而,目前各国关于紧急肺移植这一术语的定义、标准和应用并不统一,且基于该分配制度的肺移植受者术后生存和净获益也存在较多争议。本文基于既往紧急肺移植的临床研究,对其定义标准、危险因素、生存结果、局限性和优化措施进行详细综述,为综合评估紧急肺移植的可行性并进一步优化肺源分配制度提供理论参考。

     

    Abstract: Lung transplantation is the only effective treatment of end-stage lung diseases. Nevertheless, shortage of donor lungs has become increasingly prominent worldwide. A large quantity of patients died while waiting for lung transplantation. Urgent lung transplantation is a prioritized allocation strategy for donor lung transplantation according to the urgency of diseases, aiming to shorten the waiting time for donor lungs and reduce the fatality of patients on the waiting list for lung transplantation. However, no consensus has been reached worldwide on the definition, criteria and application of the terminology of urgent lung transplantation. In addition, the survival and net benefits of lung transplant recipients based on this allocation system are still controversial. On the basis of previous clinical research on urgent lung transplantation, the definition criteria, risk factors, survival outcomes, limitations and optimization measures were explicitly elucidated in this article, aiming to provide theoretical reference for comprehensive evaluation of the feasibility of urgent lung transplantation and further optimizing the allocation system of donor lungs.

     

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