器官移植2025，Vol.16Issue(6)：890-897,8.DOI:10.12464/j.issn.1674-7445.2025188
间质性肺病行二次肺移植的临床特点分析
Clinical characteristics analysis of interstitial lung disease undergoing second lung transplantation
摘要
Abstract
Objective To analyze the clinical characteristics of recipients with interstitial lung disease(ILD)who underwent second lung transplantation and summarize the diagnostic and therapeutic experience.Methods A retrospective analysis was conducted on the clinical data of 14 patients who underwent first and second lung transplants for ILD at the First Affiliated Hospital of Guangzhou Medical University from January 2015 to December 2024.The preoperative conditions,intraoperative events,postoperative treatments and prognoses of the first and second lung transplantation were compared,and the postoperative survival of ILD patients after the second lung transplantation was analyzed.Results Among the 14 recipients of the second lung transplant,13 underwent the procedure due to chronic lung allograft dysfunction,and 1 due to airway complications.The median interval time from the first to the second lung transplant was 32(2,80)months.Before the second transplantation,2 recipients required endotracheal intubation and mechanical ventilation,and 2 required endotracheal intubation,mechanical ventilation,and extracorporeal membrane oxygenation(ECMO)support.The surgical time for the second lung transplantation was longer than that for the first,with increased intraoperative red blood cell and plasma transfusion volumes,the proportion of ECMO support during the second lung transplantation was higher than that during the first(all P<0.05).However,the cold ischemia time for one-sided lung transplant completion in the first lung transplant was similar to that in the second lung transplantation(P>0.05).The median follow-up time after the second lung transplantation was 32(1,63)months.The 1-month,6-month and 1-year survival rates after the second lung transplantation were 79%,57%and 50%,respectively,with causes of death being infection,multiple organ failure and gastrointestinal bleeding.Conclusions For ILD patients undergoing second lung transplantation after the first lung transplantation,the second lung transplantation is more challenging,with longer surgical time and higher intraoperative blood loss.It requires higher surgical skills and perioperative management.Non-emergency second transplantation may still achieve good results.关键词
间质性肺病/肺移植/二次肺移植/围手术期/术后并发症/预后/体外膜肺氧合/原发性移植物失功Key words
Interstitial lung disease/Lung transplantation/Second lung transplantation/Perioperative period/Postoperative complication/Prognosis/Extracorporeal membrane oxygenation/Primary graft dysfunction分类
医药卫生引用本文复制引用
刘梦杨,周延然,彭桂林,杨超,杨汉宇,刘辉,徐鑫..间质性肺病行二次肺移植的临床特点分析[J].器官移植,2025,16(6):890-897,8.基金项目
国家自然科学基金面上项目(82470103) （82470103）
广州国家实验室专项项目(GZNL2023A01003) （GZNL2023A01003）
