https://scholars.lib.ntu.edu.tw/handle/123456789/584330
標題: | Twenty-years of lung transplantation in Taiwan: Effects of cumulative institutional experience on early outcomes | 作者: | SHUN-MAO YANG SHU-CHIEN HUANG SHUENN-WEN KUO PEI-MING HUANG PO-NI HSIAO KE-CHENG CHEN MONG-WEI LIN SUNG-CHING PAN JUI-HSIANG LIN YA-JUNG CHENG JANG-MING LEE HSAO-HSUN HSU |
公開日期: | 2017 | 出版社: | Elsevier B.V. | 卷: | 116 | 期: | 11 | 起(迄)頁: | 862-868 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background/purpose Lung transplantation in Taiwan began in 1991, but the experience was limited and diverse in the early years. We examined the cumulative institutional experience of the largest lung transplant cohort in Taiwan. Methods A retrospective review of lung transplantations performed at a single institution from December 1995 through August 2016 was conducted. For comparative purposes, the cohort was divided into halves, with an early group (undergoing lung transplantation in the first decade) vs a late group (undergoing lung transplantation in the second decade). Standardized donor selection, organ procurement, and preservation protocols for brain-dead donors were applied. The outcomes measured were 30-day mortality and actuarial survival using the Kaplan–Meier method. Results The cohort included 50 recipients in the early group and 42 recipients in the late group. Compared with the early group, recipients in the late group were significantly older (38.8 ± 11.6 vs 44.8 ± 13.4 years, p = 0.024) and more of them required mechanical ventilation before transplant (26.0% vs 66.7%, p < 0.001). There were more female donors (12.0% vs 33.3%, p = 0.021) and gender-matched donors (34.0% vs 61.9%, p = 0.012) in the late group. A total of 87 recipients (94.6%) had cardiopulmonary bypass (CPB) or extracorporeal membrane oxygenation (ECMO) support during transplant, and CPB was used significantly less in the late group. Graft procedures (14.0% vs 47.6%, p < 0.001), delayed chest closure (0% vs 21.4%, p < 0.001), and early tracheostomy (24.0% vs 52.4%, p = 0.005) were performed more in the late group. The durations of hospital and ICU stays were comparable in both groups, but the 30-day mortality was significantly lower in the late group (30.0% vs 2.4%, p = 0.001). Conclusion Although the results were undesirable in the first decade of the transplant program, the cumulative institutional experience led to significantly improved outcomes in the second decade of the transplant program. © 2017 |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85029881483&doi=10.1016%2fj.jfma.2017.08.011&partnerID=40&md5=c990b0c8244806e12e99b92ba543f6a1 https://scholars.lib.ntu.edu.tw/handle/123456789/584330 |
ISSN: | 0929-6646 | DOI: | 10.1016/j.jfma.2017.08.011 |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。