儿童肺移植临床研究进展  

Clinical research progress on pediatric lung transplantation

作　　者：李慧星 毛文君 Li Huixing;Mao Wenjun(Department of Thoracic Surgery,Wuxi People’s Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China)

机构地区：[1]南京医科大学附属无锡人民医院胸外科,江苏无锡214023

出　　处：《器官移植》2022年第3期344-348,共5页Organ Transplantation

基　　金：江苏省科教强卫工程青年医学重点人才项目(QNRC2016193)。

摘　　要：肺移植是治疗儿童终末期肺病的有效手段。供肺来源短缺,供、受者匹配度差,术后管理难度大,术后并发症多,病死率高等原因制约了儿童肺移植的发展。但随着公民器官捐献的推广、医学科学技术的进步以及肺移植经验的积累,各移植中心取得了长足进步。近年来,脑死亡器官捐献供肺和边缘供肺修复临床应用、围手术期生命支持技术及外科移植术式的成熟、成人肺移植术后管理经验的借鉴使得儿童肺移植发展迅速。本文介绍了国内外肺移植中心关于儿童肺移植原发病、供肺利用及分配、外科手术技术选择、并发症处理及预后等方面的现状和进展,旨在为临床诊治提供借鉴。Lung transplantation is an efficacious treatment for end-stage lung diseases in children.Shortage of donor lungs,poor donor-recipient matching,difficult postoperative management,multiple postoperative complications and high fatality jointly restrict the development of pediatric lung transplantation.However,significant progress has been achieved in each transplantation center along with the popularization of organ donation after citizen’s death,advancement of medical science and technology and accumulation of lung transplantation experience.In recent years,clinical application of donor lung from donation after brain death and marginal donor lung repair,maturity of perioperative life support technology and surgical transplantation procedure and reference of management experience after adult lung transplantation have accelerated rapid development of pediatric lung transplantation.In this article,current status and progress on primary diseases,utilization and allocation of donor lungs,selection of surgical techniques,management of postoperative complications and clinical prognosis of pediatric lung transplantation were elucidated,aiming to provide reference for clinical diagnosis and treatment.

关 键 词：儿童肺移植 手术方式 脑死亡器官捐献 离体肺灌注(EVLP) 肺源分配评分 体外膜肺氧合(ECMO) 慢性移植肺功能障碍(CLAD) 闭塞性细支气管炎综合征(BOS) 

分 类 号：R617[医药卫生—外科学] R563[医药卫生—临床医学]