Abstract

Purpose: The influence of allograft ischemic time (IT) on short- and long-term mortality remains under debate in lung transplantation (LTx). Due to a scarcity in donors, better understanding of IT might improve the outcome after LTx. Methods: Between January 1990 and June 2016; 307 patients underwent LTx at Lund university hospital, Sweden. The end-point used was death/Re-LTx assessed by Cox regression and Kaplan–Meier survival. Results: Kaplan–Meier survival for mean IT (min) between subgroups ≤120, 121–240, 241–360 and 361+ showed significant difference for pairwise-comparisons with superior outcome for IT between ≤120 and 240 min. Cox regression analyses for each hour of IT in patients with a limited survival up to 1- and 5-year had a hazard ratio (HR) of 1.119 and 1.063 respectively (p < .05). Conclusions: In LTx, every 2-hour increase of IT is equivalent to an increased mortality of up to 24% within 5 years. LTx with an IT of ≤120 min had a superior survival in both 1- and 5 years in comparison to an IT of up to 360 min. Better application of IT provides a key role in improving LTx outcome.

摘要

目的：同种异体移植缺血时间（IT）对短期和长期死亡率的影响在肺移植（LTx）中仍存在争议。由于捐助者的短缺，更好地了解IT可能会改善LTx后的结果。方法： 1990年1月至2016年6月; 307名患者在瑞典隆德大学医院接受LTx治疗。使用的终点是通过Cox回归和Kaplan-Meier生存评估的死亡/ Re-LTx。结果：≤120、121–240、241–360和361+的亚组之间的平均IT（min）的Kaplan–Meier生存率在成对比较中显示出显着差异，IT≤120和240 min的结果更为优越。对于生存时间有限（长达1年和5年）的患者，每小时IT的Cox回归分析的危险比（HR）分别为1.119和1.063（p  <.05）。结论：在LTx中，IT的每2小时增加相当于5年内死亡率增加高达24％。IT≤120分钟的LTx在1年和5年中的生存期均优于360分钟的IT。更好地应用IT可以在改善LTx结果方面发挥关键作用。