초록접수 현황
| 16F-270 | 구연 발표 |
20 Year Experience in Lung Transplantation
Jee Won Suh, Seokkee Lee, Kyoung Sik Narm, Chang Young Lee, Jin Gu Lee, Hyo Chae Paik
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Background : LTx is the only therapeutic option for end stage lung disease. The first LTx was performed in 1996 and there has been a lot of advancement. The purpose of this study is to review our data and recent trends in the field of LTx in Korea.
Methods : A retrospective review of patients who underwent LTx from July 1996 to July 2016 were performed. Donor and recipient baseline characteristics, waiting time and PGD were analyzed. Patient survival was compared only in patients who were operated in the era in which more than 10 cases of LTx were performed annually.
Results : Total of 173 cases of LTx were performed (86.1% was bilateral and 10.9% was single). There were 5 (2.8%) re-transplantations. Major indications for transplantation were IPF (51%), CTD related ILD (11%), bronchiectasis (9%) and BOS (9%). Total operation time was decreased (489.67min in 2010, 401.50min in 2016,p=0.033). Right and left lung ischemic time slightly increased (mean 177 and 290 in 2010 to 241 and 346 in 2016, p<0.05). 90 days mortality was 27.3% in 2010 compared to 4.8% in 2016 (p=0.128). Recipient age has increased where more than 10 % of patients were over the age of 65 years since 2012. The use of ECMO as a bridge to LTx increased to 11 cases (26.8%) in 2015. More donors with extended criteria (ECD) were utilized although there was no significant difference in the incidence of grade 3 PGD between the SCD versus ECD group (p>0.05). Overall survival improved in last five year (1-year survival was 46.2% vs 63.1%, 4-year survival was 38.5% vs 51%).
Conclusion : In recent years, there was a trend towards more usage of ECMO and ECD with better short and long-term patient survival. Improvements in surgical techniques, therapeutic agents, collaborative team support were the main reason for the improved survival.
Methods : A retrospective review of patients who underwent LTx from July 1996 to July 2016 were performed. Donor and recipient baseline characteristics, waiting time and PGD were analyzed. Patient survival was compared only in patients who were operated in the era in which more than 10 cases of LTx were performed annually.
Results : Total of 173 cases of LTx were performed (86.1% was bilateral and 10.9% was single). There were 5 (2.8%) re-transplantations. Major indications for transplantation were IPF (51%), CTD related ILD (11%), bronchiectasis (9%) and BOS (9%). Total operation time was decreased (489.67min in 2010, 401.50min in 2016,p=0.033). Right and left lung ischemic time slightly increased (mean 177 and 290 in 2010 to 241 and 346 in 2016, p<0.05). 90 days mortality was 27.3% in 2010 compared to 4.8% in 2016 (p=0.128). Recipient age has increased where more than 10 % of patients were over the age of 65 years since 2012. The use of ECMO as a bridge to LTx increased to 11 cases (26.8%) in 2015. More donors with extended criteria (ECD) were utilized although there was no significant difference in the incidence of grade 3 PGD between the SCD versus ECD group (p>0.05). Overall survival improved in last five year (1-year survival was 46.2% vs 63.1%, 4-year survival was 38.5% vs 51%).
Conclusion : In recent years, there was a trend towards more usage of ECMO and ECD with better short and long-term patient survival. Improvements in surgical techniques, therapeutic agents, collaborative team support were the main reason for the improved survival.
책임저자: Hyo Chae Paik
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
발표자: Hyo Chae Paik, E-mail : hcpaik@yuhs.ac