肺移植后慢性肺移植物功能障碍与严重残疾相关——1025例疾病负担分析。

IF 1.8 Q3 RESPIRATORY SYSTEM Advances in respiratory medicine Pub Date : 2023-10-12 DOI:10.3390/arm91050033
Roland Diel, Susanne Simon, Jens Gottlieb
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引用次数: 0

摘要

背景:慢性肺移植功能障碍(CLAD)是肺移植术后第一年死亡的主要原因。目的:评估每位严重CLAD患者的残疾调整生命年数。方法:对2010年至2020年间在德国汉诺威医学院接受肺移植的患者的临床和人口学数据进行评估。结果:共有1025名肺移植患者接受了随访,平均随访51个月(4.25年);移植时的中位年龄为52.8(四分位间距(IQR)19)岁。超过四分之一的移植患者(271/1025或26.4%)出现CLAD,大多数(60%)为闭塞性细支气管炎综合征(BOS)表型。在CLAD患者中,99名(36.5%)患有严重残疾,平均发生在2年后(IQR 2.55)。移植后有残疾的CLAD患者的存活率明显低于无CLAD的患者(中位数4.04年对5.41年)。根据DALY估计方法进行调整后,CLAD患者失去了1.29个生命年(YLL),并因其残疾(YLD)生活了0.8年,每个患者的DALY总计为2.09个(范围1.99-2.72)。结论:肺移植后CLAD是一个主要的公共卫生问题,与严重的残疾和费用有关。需要进一步的工作来制定减少其发展的治疗干预措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Chronic Lung Allograft Dysfunction Is Associated with Significant Disability after Lung Transplantation-A Burden of Disease Analysis in 1025 Cases.

Background: Chronic lung allograft dysfunction (CLAD) is the leading cause of death after the first postoperative years of lung transplantation (LTx).

Objective: To assess the number of disability-adjusted life years (DALYs) per patient with severe CLAD.

Methods: The clinical and demographic data of patients who received their lung transplantation between 2010 and 2020 in the Hanover Medical School (Germany) were evaluated.

Results: A total of 1025 lung transplant patients were followed for a median of 51 months (4.25 years); the median age at transplantation was 52.8 (interquartile range (IQR) 19) years. More than a quarter of transplant patients (271/1025 or 26.4%) developed CLAD, mostly (60%) of the bronchiolitis obliterans syndrome (BOS) phenotype. Of the CLAD patients, 99, or 36.5%, suffered from significant disability, which on average occurred after 2 years (IQR 2.55). The survival of CLAD patients with disability after transplantation was significantly lower compared to that of patients without CLAD (median 4.04 versus 5.41 years). Adjusted to the DALY estimation approach, CLAD patients lost 1.29 life years (YLL) and lived for 0.8 years with their disability (YLD), adding up to 2.09 DALYs (range 1.99-2.72) per patient.

Conclusions: CLAD after lung transplantation is a major public health problem and is associated with substantial disability and costs. Further work is needed to develop therapeutic interventions that reduce its development.

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来源期刊
Advances in respiratory medicine
Advances in respiratory medicine RESPIRATORY SYSTEM-
CiteScore
2.60
自引率
0.00%
发文量
90
期刊介绍: "Advances in Respiratory Medicine" is a new international title for "Pneumonologia i Alergologia Polska", edited bimonthly and addressed to respiratory professionals. The Journal contains peer-reviewed original research papers, short communications, case-reports, recommendations of the Polish Respiratory Society concerning the diagnosis and treatment of lung diseases, editorials, postgraduate education articles, letters and book reviews in the field of pneumonology, allergology, oncology, immunology and infectious diseases. "Advances in Respiratory Medicine" is an open access, official journal of Polish Society of Lung Diseases, Polish Society of Allergology and National Research Institute of Tuberculosis and Lung Diseases.
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