心脏死亡供肺肺移植临床分析  

Clinical Analysis of Lung Transplantation from Donor of Cardiac Death

作　　者：蒋华驰 陈员[1] 陈静瑜[1] 

机构地区：[1]南京医科大学附属无锡市人民医院胸外科,江苏无锡214023

出　　处：《南京师大学报（自然科学版）》2017年第2期92-97,共6页Journal of Nanjing Normal University(Natural Science Edition)

基　　金：南京医科大学科技发展基金面上项目(2015NJ-MU146)

摘　　要：探讨心脏死亡供体(DCD)肺移植围手术期供肺保护策略对肺移植术后的疗效.回顾性分析2015年1月至2015年12月无锡市人民医院肺移植中心完成的21例DCD供肺移植的临床资料,受者原发病种包括肺间质纤维化9例,慢性阻塞性肺疾病4例,支气管扩张4例,硅肺2例,肺结核毁损肺1例,特发性肺动脉高压1例.总结分析供肺术前维护策略及受者术后早期死亡原因.21例受者手术过程顺利,术后5例受者早期死亡(<30 d),原因包括2例肺部感染,1例原发性移植物功能丧失(PGD),1例急性排斥反应(AR),1例肺栓塞.受者术后肺功能较术前显著改善,术后1年存活率76.1%.心脏死亡供肺经有效维护供肺可扩展供肺数量.To investigate the outcome of lung management for donors after cardiac death （ DCD） during preoperative period. 21 lung transplantations from DCD donors were performed in Wuxi People＇s Hospital from January 2015 to November 2015. In which there were 9 pulmonary fibrosis,4 chronic obstructive pulmonary disease,4 bronchiectasis,2 silicosis, 1 pulmonary tuberculosis, 1 idiopathic pulmonary arterial hypertension. We retrospectively summarized the donor protective strategies and analyzed the causes of early death of recipients. 21 lung transplants were performed successfully. In-hospital mortality （ 〈30 d）was 5/21. Death after transplantation was due to infection （n = 2） , primary lung graft dysfunction function （ n=1） , acute rejection （ n=1） , pulmonary vein embolism （ n=1） . The 1 -year survival rate after lung transplants was 76.1% and the pulmonary function was improved significantly. The application of effective management in donors of cardiac could be used to significantly increase the donor pool.

关 键 词：心脏死亡 供肺管理 肺移植 

分 类 号：R655[医药卫生—外科学]