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1.
Organ Transplantation ; (6): 743-2020.
Article in Chinese | WPRIM | ID: wpr-829690

ABSTRACT

Acute kidney injury (AKI) is one of the common early complications after lung transplantation, which not only increases the short-term and long-term fatality of lung transplant recipients, but also significantly increases the incidence of long-term chronic renal insufficiency after surgery. In recent years, early AKI after lung transplantation has attracted high attention along with the rapid development of lung transplantation in China. In this article, research progresses on diagnosis, incidence, risk factors, prevention and treatment of early AKI after lung transplantation around the globe were reviewed, aiming to better identify the risk factors and poor prognosis of early AKI after lung transplantation, and provide theoretical and practical guidance for early clinical interventions.

2.
Organ Transplantation ; (6): 391-2020.
Article in Chinese | WPRIM | ID: wpr-821548

ABSTRACT

Objective To investigate the clinical efficacy and prognosis of lung transplantation in the treatment of cystic fibrosis (CF). Methods Clinical data of one patient with end-stage CF undergoing allogeneic bilateral lung transplantation were retrospectively analyzed. Clinical characteristics, diagnostic methods and treatment strategies of the CF recipient were summarized. Results The recipient had suffered from relevant symptoms since childhood including repeated cough and purulent sputum for 30 years, complicated with recurrent pulmonary infection combined with acute exacerbation, chronic sinusitis and extremely severe malnutrition. Prior to lung transplantation, the patient had to depend upon the invasive ventilator due to respiratory muscle weakness, and admitted to intensive care unit (ICU) for a long time. Imaging examination revealed multiple cystic columnar bronchiectasis accompanied with infection in bilateral lungs. The diagnosis of CF was further confirmed by sweat test and gene detection. The recipient underwent bilateral lung transplantation on August 17, 2017 and received rehabilitation treatment. The lung function was gradually restored to normal. The recipient had obtained the same quality of life to the healthy counterparts since the date of manuscript submission (over 2 years). Conclusions Lung transplantation is an efficacious treatment for end-stage CF, which can not only save patients' lives, but also significantly improve the quality of life of patients.

3.
Article in Chinese | WPRIM | ID: wpr-870598

ABSTRACT

Objective:To explore the clinical value of lobar lung transplantation for end-stage lung disease patients in organ donation era.Methods:Clinical data were analyzed retrospectively for 14 cases with lobar lung transplantations between January 2016 and December 2019, including clinical outcomes and postoperative complications.Results:Eleven cases(78.6 %)had a positive etiology examination in bronchial secretion or tissue culture. There were unilateral lobar lung transplantation (n=2), bilateral lobar lung transplantation(n=2)and unilateral lobar lung transplantation and contralateral lung transplantation(n=10). Intra-operative ECMO(n=11)postoperative ECMO(n=5)were required. All survived during a 30-day perioperative period. The median time of postoperative ECMO was 1(1~11)day, the median time of extubation 4.5(0~182)day and the median time of stay in ICU 11(2~186)day. Re-operation was required for 1 case due to active bleeding in thoracic cavity. There were 10 survivors and 4 deaths. The causes of death were bronchus fistula(n=2), pulmonary infection(n=1)and renal failure(n=1)respectively.Conclusions:Lobar lung transplantation is efficacious for selected patients with end-stage lung disease.

4.
Article in Chinese | WPRIM | ID: wpr-870560

ABSTRACT

Objective:To explore the significance of US lung allocation score (LAS) in Chinese lung transplant recipients.Methods:The clinical data were analyzed for 173 lung recipients from May 2005 to March 2018. The LAS of each patient was calculated by an online LAS calculator of Organ Procurement and Transplantation Network (OPTN).Results:The mean age was (56.49±12.64) years and the mean LAS (56.63±18.39)(32.79-90.70). The underlying diseases were chronic obstructive pulmonary disease (COPD, n=62), interstitial lung disease (n=85), bronchiectasis (n=11), pulmonary arterial hypertension (n=8) and others (n=7). And the value of LAS was (47.85±15.22) vs. (61.89±18.63) vs. (56.58±18.91) vs. (55.23±10.74) vs. (72.45±16.41). LAS of COPD patients was significantly lower than that of interstitial lung disease ( P<0.001). Mean LAS was the highest in endotracheal intubation or ECMO group (79.15±7.95), then non-invasive ventilation group (48.42±11.58) and lowest in oxygen inhalation group (44.11±8.81)( P<0.001). Recipients were divided into three groups of LAS <50 for low-risk, 50-75 for moderate-risk and >75 for high-risk. Survivals at 90 days and 1 year were 90.5% vs. 81.8% vs. 71.1% and 85.4% vs. 74.4% vs. 57.8% ( P=0.002). Conclusions:LAS can not only reflect the urgency of recipients waiting for lung transplantation but also predict postoperative period. LAS score should be employed for selecting suitable lung transplant recipients in China and the optimal LAS lies between 30 and 75.

5.
Article in Chinese | WPRIM | ID: wpr-662898

ABSTRACT

Objective To report the results of lung transplantation using graft lungs from donation after citizens death.Methods The clinical data of lung transplantation between January 2016 and June 2016 were analyzed retrospectively.Results Totally 20 patients with end stage lung diseases underwent lung transplantation.Of the 20 patients,11 cases (55%) underwent single lung transplantation and 9 cases (45 %) underwent bilateral lung transplantation.The top two diseases for lung transplantation were pulmonary fibrosis in 11 cases (55%) and emphysema in 6 cases (30%).Four cases (20%) were given intraoperative ECMO support.Median duration of postoperative intubation was 2 days:1 day for single lung transplantation and 4 days for bilateral lung transplantation,respectively.Acute rejections were diagnosed in 9 patients (45%) who were successfully treated with high-dose intravenous methylprednisolone or methylprednisolone combined with anti-human thymocyte globulin.Postoperative pneumonia episodes occurred in 16 cases (80%)and 4 of them were associated fungal pneumonia.Preoperative sputum culture showed positive bacteria in 16 donors (80%) and 17 kinds of strains were identified.Postoperative sputum culture showed positive bacteria in 19 recipients and 4 of them had the same strains as compared with the corresponding donors.One recipient died of primary graft dysfunction in early term (< 1 month)postoperatively,two recipients abandoned treatments and died in 1 week after the discharge,and the remaining 17 cases successfully recovered.Median hospital duration was 55 days:35 days for single lung transplantation and 67 days for bilateral lung transplantation,respectively.Conclusion LLung transplantation is an effective treatment for end-stage lung diseases.Carefully selecting donors,well protecting graft lung and proper peri-operative treatment are the key steps leading to successful lung transplantation using grafts from organ procurement organization.

6.
Article in Chinese | WPRIM | ID: wpr-660974

ABSTRACT

Objective To report the results of lung transplantation using graft lungs from donation after citizens death.Methods The clinical data of lung transplantation between January 2016 and June 2016 were analyzed retrospectively.Results Totally 20 patients with end stage lung diseases underwent lung transplantation.Of the 20 patients,11 cases (55%) underwent single lung transplantation and 9 cases (45 %) underwent bilateral lung transplantation.The top two diseases for lung transplantation were pulmonary fibrosis in 11 cases (55%) and emphysema in 6 cases (30%).Four cases (20%) were given intraoperative ECMO support.Median duration of postoperative intubation was 2 days:1 day for single lung transplantation and 4 days for bilateral lung transplantation,respectively.Acute rejections were diagnosed in 9 patients (45%) who were successfully treated with high-dose intravenous methylprednisolone or methylprednisolone combined with anti-human thymocyte globulin.Postoperative pneumonia episodes occurred in 16 cases (80%)and 4 of them were associated fungal pneumonia.Preoperative sputum culture showed positive bacteria in 16 donors (80%) and 17 kinds of strains were identified.Postoperative sputum culture showed positive bacteria in 19 recipients and 4 of them had the same strains as compared with the corresponding donors.One recipient died of primary graft dysfunction in early term (< 1 month)postoperatively,two recipients abandoned treatments and died in 1 week after the discharge,and the remaining 17 cases successfully recovered.Median hospital duration was 55 days:35 days for single lung transplantation and 67 days for bilateral lung transplantation,respectively.Conclusion LLung transplantation is an effective treatment for end-stage lung diseases.Carefully selecting donors,well protecting graft lung and proper peri-operative treatment are the key steps leading to successful lung transplantation using grafts from organ procurement organization.

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