哮喘联盟

   摘要
   目的：肺移植捐赠者和接受者的之前吸烟状况对移植后生存率的影响还不明确，尤其是在囊性纤维化的患者中。我们力求确定捐赠者和接受者的吸烟状况是否与患有囊性纤维化的肺移植患者包括生存的预后差别相关。
   材料与方法：搜索美国器官捐献网络数据库，分析大量有肺移植史的囊性纤维化患者。本研究的主要观察终点是基于接受者或捐献者吸烟史的移植后总生存率。
   结果：囊性纤维化患者接受的肺来自有吸烟史捐献者时其生存率会显著降低(P = .026), 但接受者的个人吸烟史与生存率无关。几乎60%的接受了来自吸烟捐献者肺的受试者在本研究期间死亡。捐献者吸烟史与生存率在单变量分析中具有相关性 (HR 1.2, [1.04-1.3 ]), 但是在多变量模型中则没有。捐献者吸烟史也与移植后第一年排斥反应治疗增加相关(P = .005).
   结论：捐献者超过20包-年的吸烟史可能会影响囊性纤维化患者肺移植的预后(例如, 生存率和急性排斥反应)。为囊性纤维化患者选择合适的器官捐献者时必须谨慎。

 

（苏欣 审校）
Exp Clin Transplant. 2015 Dec;13(6):529-34.

 

Cigarette Smoking Effect on Survival After Lung Transplant in Cystic Fibrosis.
 

Kopp BT1, Groner J, Tobias JD, Whitson BA, Kirkby S, Hayes D Jr.
 

Abstract
OBJECTIVES:The effect of prior cigarette use by lung transplant donors and recipients on posttransplant survival is poorly defined, especially in subjects with cystic fibrosis. We sought to determine if donor or recipient cigarette smoking is associated with differential post lung transplant outcomes in cystic fibrosis patients, including survival.
MATERIALS AND METHODS:The United Network for Organ Sharing database was searched to analyze a large sample of cystic fibrosis patients with a history of lung transplant. The primary endpoint of the study was overall survival after transplant based on either recipient or donor history of smoking cigarettes.
RESULTS:There was a significant decrease in survival for cystic fibrosis patients who received lungs from a donor with a history of smoking (P = .026), but no difference in survival for recipients with a personal history of smoking. Nearly 60% of subjects who received lungs from a smoking donor died during the study. Donor smoking history was correlated with survival in a univariate (HR 1.2, [1.04-1.3 ]), but not multivariate model. Donor smoking history also was associated with increased treatment for rejection within the first year after transplant (P = .005).
CONCLUSIONS:More than 20 pack-year history of donor smoking may affect lung transplant outcomes (eg, survival and acute rejection) in patients with cystic fibrosis. Caution must be exercised when choosing suitable organ donors for cystic.
 

Exp Clin Transplant. 2015 Dec;13(6):529-34.