초록접수 현황
| 19F-123 | 구연 발표 |
Long-term outcome after lung transplantation based on chronic rejection
Jee Won Suh¹, Ha Eun Kim¹, Seong Yong Park¹, Chang Young Lee¹, Jin Gu Lee¹, Dae Joon Kim¹, Kyoung Young Chung¹, Su Jin Jeong², Moo Suk Park³, Song Yee Kim³, Hyo Chae Paik¹
¹Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea, ²Division of Infectious Disease, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea, ³Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Purpose : Survival is significantly shorter after lung transplantation compared to other solid organ transplantation, with chronic rejection as a contributing factor. This study was aimed to evaluate the long-term survival and chronic rejection rate after lung transplantation in a single institution.
Methods : From 2010 to 2017, 213 patients underwent lung transplantation in our institute. Ninety-four patients were excluded because of death within 1 year after surgery or lack of follow-up pulmonary function test data. The patients were divided into two groups according to the presence or absence of grade ≥2 bronchiolitis obliterans syndrome (BOS). Data on baseline characteristics, perioperative outcomes, pulmonary function test results, and survival were analyzed.
Results : Twenty-nine patients (24.4%) developed chronic lung allograft dysfunction (CLAD), of whom 19 (65.5%) had grade ≥2 BOS. The preoperative characteristics did not significantly differ between the groups. The incidence rates of acute cellular rejection episode (11% vs 31.6%), fungal infection (24% vs 52.6%), and CMV reactivation (35% vs 68.4%) were significantly higher in the grade ≥2 BOS group. In the multivariable analysis, acute cellular rejection episode (hazard ratio [HR], 8.687; p=0.003) and fungal infection (HR, 4.553; p=0.023) were significant risk factors of grade ≥2 BOS. The 3-year overall survival rate was 84.5%, and the CLAD-free survival rate was 76.9% in the 1-year conditional survivors.
Conclusion : Considering lung exposure to the environment and increased susceptibility to infection, management of postoperative infections is important in order to improve the long-term survival after lung transplantation.
Methods : From 2010 to 2017, 213 patients underwent lung transplantation in our institute. Ninety-four patients were excluded because of death within 1 year after surgery or lack of follow-up pulmonary function test data. The patients were divided into two groups according to the presence or absence of grade ≥2 bronchiolitis obliterans syndrome (BOS). Data on baseline characteristics, perioperative outcomes, pulmonary function test results, and survival were analyzed.
Results : Twenty-nine patients (24.4%) developed chronic lung allograft dysfunction (CLAD), of whom 19 (65.5%) had grade ≥2 BOS. The preoperative characteristics did not significantly differ between the groups. The incidence rates of acute cellular rejection episode (11% vs 31.6%), fungal infection (24% vs 52.6%), and CMV reactivation (35% vs 68.4%) were significantly higher in the grade ≥2 BOS group. In the multivariable analysis, acute cellular rejection episode (hazard ratio [HR], 8.687; p=0.003) and fungal infection (HR, 4.553; p=0.023) were significant risk factors of grade ≥2 BOS. The 3-year overall survival rate was 84.5%, and the CLAD-free survival rate was 76.9% in the 1-year conditional survivors.
Conclusion : Considering lung exposure to the environment and increased susceptibility to infection, management of postoperative infections is important in order to improve the long-term survival after lung transplantation.
책임저자: Hyo Chae Paik
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
발표자: Jee Won Suh, E-mail : suh_1225@yuhs.ac