Cargando…
Lung transplantation for bronchiolitis obliterans after hematopoietic stem cell transplantation: a retrospective single-center study
BACKGROUND: Bronchiolitis obliterans (BO) is one of the most common late non-infectious pulmonary complications after hematopoietic stem cell transplantation (HSCT). Lung transplantation (LT) is the only cure for patients with end-stage BO, but the overall efficacy is rarely reported. Our study aims...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9279806/ https://www.ncbi.nlm.nih.gov/pubmed/35845538 http://dx.doi.org/10.21037/atm-22-2517 |
_version_ | 1784746483630735360 |
---|---|
author | Liang, Jialong Chen, Yuan Zhou, Jintao Li, Huixing Zheng, Mingfeng Liu, Feng Ye, Shugao Chen, Jingyu Ji, Yong |
author_facet | Liang, Jialong Chen, Yuan Zhou, Jintao Li, Huixing Zheng, Mingfeng Liu, Feng Ye, Shugao Chen, Jingyu Ji, Yong |
author_sort | Liang, Jialong |
collection | PubMed |
description | BACKGROUND: Bronchiolitis obliterans (BO) is one of the most common late non-infectious pulmonary complications after hematopoietic stem cell transplantation (HSCT). Lung transplantation (LT) is the only cure for patients with end-stage BO, but the overall efficacy is rarely reported. Our study aims to conclude and elucidate the clinical experience of our single center and provide a reference for the current selection of treatment. METHODS: We retrospectively analyzed the medical records of six patients with post-HSCT BO who received LT in our center from 2015 to 2019. The collected information included demographic data, surgery-related conditions, and postoperative follow-up data, which covered blood tests, infection status assessment, lung function assessment, anesthesia assessment, function assessment of other organs and so on. All patients were regularly followed up after discharge, which in the first year, was performed every 3 months. Over the next 2 years, patients were assessed every 6 months, and after 3 years, the frequency was once annually. RESULTS: The mean age of patients at LT time was 28±13 years, with an interval of 72±48 months from HSCT. All patients developed hypercapnia with an average carbon dioxide partial pressure (pCO(2)) of 71.1±20.8 mmHg. Preoperative pulmonary function tests showed the mean actual forced expiratory volume in 1 second (FEV1) was 16.7%±5.9% of the predicted value in four patients. After assessment, four patients adopted sequential bilateral LT and two adopted right-sided LT. Due to hemodynamic instability, five patients adopted intraoperative assistance of extracorporeal membrane oxygenation (ECMO). One patient died of septic shock 9 days after surgery, and the other five survived healthy for 53±23 months. The actual value of FEV1 at 3 months postoperatively accounted for 57.9%±15.3% of the predicted value. No patients had recurrence of BO. CONCLUSIONS: LT may be a treatment worthy of consideration in patients with post-HSCT end-stage BO because it can improve lung function, quality of life and prolong survival of these selected patients. |
format | Online Article Text |
id | pubmed-9279806 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-92798062022-07-15 Lung transplantation for bronchiolitis obliterans after hematopoietic stem cell transplantation: a retrospective single-center study Liang, Jialong Chen, Yuan Zhou, Jintao Li, Huixing Zheng, Mingfeng Liu, Feng Ye, Shugao Chen, Jingyu Ji, Yong Ann Transl Med Original Article BACKGROUND: Bronchiolitis obliterans (BO) is one of the most common late non-infectious pulmonary complications after hematopoietic stem cell transplantation (HSCT). Lung transplantation (LT) is the only cure for patients with end-stage BO, but the overall efficacy is rarely reported. Our study aims to conclude and elucidate the clinical experience of our single center and provide a reference for the current selection of treatment. METHODS: We retrospectively analyzed the medical records of six patients with post-HSCT BO who received LT in our center from 2015 to 2019. The collected information included demographic data, surgery-related conditions, and postoperative follow-up data, which covered blood tests, infection status assessment, lung function assessment, anesthesia assessment, function assessment of other organs and so on. All patients were regularly followed up after discharge, which in the first year, was performed every 3 months. Over the next 2 years, patients were assessed every 6 months, and after 3 years, the frequency was once annually. RESULTS: The mean age of patients at LT time was 28±13 years, with an interval of 72±48 months from HSCT. All patients developed hypercapnia with an average carbon dioxide partial pressure (pCO(2)) of 71.1±20.8 mmHg. Preoperative pulmonary function tests showed the mean actual forced expiratory volume in 1 second (FEV1) was 16.7%±5.9% of the predicted value in four patients. After assessment, four patients adopted sequential bilateral LT and two adopted right-sided LT. Due to hemodynamic instability, five patients adopted intraoperative assistance of extracorporeal membrane oxygenation (ECMO). One patient died of septic shock 9 days after surgery, and the other five survived healthy for 53±23 months. The actual value of FEV1 at 3 months postoperatively accounted for 57.9%±15.3% of the predicted value. No patients had recurrence of BO. CONCLUSIONS: LT may be a treatment worthy of consideration in patients with post-HSCT end-stage BO because it can improve lung function, quality of life and prolong survival of these selected patients. AME Publishing Company 2022-06 /pmc/articles/PMC9279806/ /pubmed/35845538 http://dx.doi.org/10.21037/atm-22-2517 Text en 2022 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Liang, Jialong Chen, Yuan Zhou, Jintao Li, Huixing Zheng, Mingfeng Liu, Feng Ye, Shugao Chen, Jingyu Ji, Yong Lung transplantation for bronchiolitis obliterans after hematopoietic stem cell transplantation: a retrospective single-center study |
title | Lung transplantation for bronchiolitis obliterans after hematopoietic stem cell transplantation: a retrospective single-center study |
title_full | Lung transplantation for bronchiolitis obliterans after hematopoietic stem cell transplantation: a retrospective single-center study |
title_fullStr | Lung transplantation for bronchiolitis obliterans after hematopoietic stem cell transplantation: a retrospective single-center study |
title_full_unstemmed | Lung transplantation for bronchiolitis obliterans after hematopoietic stem cell transplantation: a retrospective single-center study |
title_short | Lung transplantation for bronchiolitis obliterans after hematopoietic stem cell transplantation: a retrospective single-center study |
title_sort | lung transplantation for bronchiolitis obliterans after hematopoietic stem cell transplantation: a retrospective single-center study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9279806/ https://www.ncbi.nlm.nih.gov/pubmed/35845538 http://dx.doi.org/10.21037/atm-22-2517 |
work_keys_str_mv | AT liangjialong lungtransplantationforbronchiolitisobliteransafterhematopoieticstemcelltransplantationaretrospectivesinglecenterstudy AT chenyuan lungtransplantationforbronchiolitisobliteransafterhematopoieticstemcelltransplantationaretrospectivesinglecenterstudy AT zhoujintao lungtransplantationforbronchiolitisobliteransafterhematopoieticstemcelltransplantationaretrospectivesinglecenterstudy AT lihuixing lungtransplantationforbronchiolitisobliteransafterhematopoieticstemcelltransplantationaretrospectivesinglecenterstudy AT zhengmingfeng lungtransplantationforbronchiolitisobliteransafterhematopoieticstemcelltransplantationaretrospectivesinglecenterstudy AT liufeng lungtransplantationforbronchiolitisobliteransafterhematopoieticstemcelltransplantationaretrospectivesinglecenterstudy AT yeshugao lungtransplantationforbronchiolitisobliteransafterhematopoieticstemcelltransplantationaretrospectivesinglecenterstudy AT chenjingyu lungtransplantationforbronchiolitisobliteransafterhematopoieticstemcelltransplantationaretrospectivesinglecenterstudy AT jiyong lungtransplantationforbronchiolitisobliteransafterhematopoieticstemcelltransplantationaretrospectivesinglecenterstudy |