ABSTRACT
OBJECTIVE: The time at which lung transplantation is indicated is determined by clinical and functional criteria that vary according to the particular disease. The aim of our study was to present the criteria according to which patients were placed on waiting lists for lung transplantation in our hospital. PATIENTS AND METHODS: We analyzed retrospectively the clinical characteristics, lung function, heart function, and 6-minute walk test results of patients who had received a lung transplant in our hospital from January 2002 through September 2005. RESULTS: During the study period 100 lung transplants were performed. The mean age of the patients was 45 years (range, 15-67 years) and 57% were men. The diseases that most often led to a lung transplant were chronic obstructive pulmonary disease (COPD) (35%), pulmonary fibrosis (29%), and bronchiectasis (21%). Lung function values differed by disease: mean (SD) forced expiratory volume in 1 second (FEV1) was 20% (11%) and forced vital capacity (FVC) was 37% (15%) in patients with COPD; FEV1 was 41% (15%) and FVC, 40% (17%) in patients with pulmonary fibrosis; and FEV1 was 23% (7%) and FVC, 37% (10%) in patients with bronchiectasis. CONCLUSIONS: The patients who received lung transplants in our hospital were in advanced phases of their disease and met the inclusion criteria accepted by the various medical associations when they were placed on the waiting list.
Subject(s)
Lung Diseases/diagnosis , Lung Diseases/physiopathology , Adolescent , Adult , Aged , Female , Humans , Lung Transplantation , Male , Middle Aged , Preoperative Care , Respiratory Function Tests , Retrospective Studies , Young AdultABSTRACT
OBJETIVO: El momento para indicar un trasplante pulmonar está definido por criterios clínicos y funcionales diferentes para cada enfermedad. El objetivo de este estudio es presentar cuáles fueron los criterios por los que en nuestro hospital se incluyó a los pacientes en lista de espera de trasplante pulmonar. PACIENTES Y MÉTODOS: Se ha realizado un análisis retrospectivo de las características clínicas, la función respiratoria, la prueba de la marcha de 6 minutos y el estudio cardiológico de los pacientes que recibieron un trasplante pulmonar entre enero de 2002 y septiembre de 2005. RESULTADOS: En el período estudiado se realizaron 100 trasplantes pulmonares. La edad media de los pacientes era de 45 años (rango: 15-67) y el 57% eran varones. Las enfermedades que con mayor frecuencia motivaron el trasplante pulmonar fueron la enfermedad pulmonar obstructiva crónica (EPOC, 35%), la fibrosis pulmonar (29%) y las bronquiectasias (BQ) (21%). La media ± desviación estándar de la función pulmonar osciló entre el 20 ± 11% del volumen espiratorio forzado en el primer segundo (FEV1) y el 37 ± 15% de la capacidad vital forzada (FVC) en la EPOC; del 41 ± 15% del FEV1 y el 40 ± 17% de la FVC en la fibrosis pulmonar, y del 23 ± 7% del FEV1 y el 37 ± 10% de la FVC en las BQ. CONCLUSIONES: Los pacientes que recibieron un trasplante pulmonar en nuestro centro se encontraban en fases muy evolucionadas de su enfermedad y cumplían los criterios de inclusión admitidos por las diferentes sociedades médicas cuando se les incluyó en lista de espera
OBJECTIVE: The time at which lung transplantation is indicated is determined by clinical and functional criteria that vary according to the particular disease. The aim of our study was to present the criteria according to which patients were placed on waiting lists for lung transplantation in our hospital. PATIENTS AND METHODS: We analyzed retrospectively the clinical characteristics, lung function, heart function, and 6-minute walk test results of patients who had received a lung transplant in our hospital from January 2002 through September 2005. RESULTS: During the study period 100 lung transplants were performed. The mean age of the patients was 45 years (range, 15-67 years) and 57% were men. The diseases that most often led to a lung transplant were chronic obstructive pulmonary disease (COPD) (35%), pulmonary fibrosis (29%), and bronchiectasis (21%). Lung function values differed by disease: mean (SD) forced expiratory volume in 1 second (FEV1) was 20% (11%) and forced vital capacity (FVC) was 37% (15%) in patients with COPD; FEV1 was 41% (15%) and FVC, 40% (17%) in patients with pulmonary fibrosis; and FEV1 was 23% (7%) and FVC, 37% (10%) in patients with bronchiectasis. CONCLUSIONS: The patients who received lung transplants in our hospital were in advanced phases of their disease and met the inclusion criteria accepted by the various medical associations when they were placed on the waiting list
Subject(s)
Humans , Male , Female , Middle Aged , Lung Transplantation/methods , Pulmonary Disease, Chronic Obstructive/complications , Pulmonary Fibrosis/diagnosis , Pulmonary Fibrosis/epidemiology , Spirometry/methods , Patient Selection , Plethysmography , Forced Expiratory Volume/physiology , Risk Factors , Hospitals, University , Pulmonary Disease, Chronic Obstructive/diagnosis , Lung Transplantation , Retrospective Studies , Spirometry/trends , Hypercholesterolemia/complications , Hypercholesterolemia/diagnosis , Hypertension/complications , Diabetes Mellitus/complications , Bronchiectasis/complicationsSubject(s)
Anti-Bacterial Agents/adverse effects , Kidney/drug effects , Lung Transplantation , Renal Insufficiency/chemically induced , Tobramycin/adverse effects , Administration, Inhalation , Anti-Bacterial Agents/administration & dosage , Creatinine/blood , Humans , Male , Middle Aged , Pulmonary Fibrosis/surgery , Tobramycin/administration & dosageSubject(s)
Graft Rejection/prevention & control , Immunosuppressive Agents/therapeutic use , Lung Transplantation , Sirolimus/therapeutic use , Adult , Aged , Female , Graft Rejection/physiopathology , Humans , Immunosuppressive Agents/administration & dosage , Lung Transplantation/immunology , Male , Middle Aged , Respiratory Function Tests , Sirolimus/administration & dosageSubject(s)
Coronary Artery Bypass , Mycoplasma Infections/microbiology , Pericarditis/microbiology , Pleurisy/microbiology , Postoperative Complications/microbiology , Acute Disease , Antibodies, Bacterial/blood , Antibodies, Bacterial/immunology , Humans , Male , Middle Aged , Mycoplasma/immunology , Mycoplasma Infections/diagnosis , Myocardial Infarction/surgery , SmokingABSTRACT
Fundamento: Las infecciones por hongos son una causa frecuente de morbimortalidad en los receptores de trasplante. Aspergillus spp. es un hongo ubicuo, capaz de producir diversas entidades clínicas con diferente gravedad. Objetivo: Estudiar la incidencia y gravedad de las infecciones por Aspergillus spp. en el trasplante pulmonar, analizando los diferentes cuadros clínicos y la respuesta a los fármacos antifúngicos. Métodos: Hemos revisado las historias clínicas de todos los pacientes con trasplante pulmonar y cultivos positivos para Aspergillus spp., realizados en nuestro centro entre junio de 1991 y diciembre de 1996. Resultados: Once de 49 pacientes trasplantados (22 por ciento) han desarrollado infección por Aspergillus spp. Cuatro pacientes presentaron aspergilosis invasiva y siete diferentes formas de traqueobronquitis. Han fallecido, como consecuencia directa de la infección, 3 pacientes con aspergilosis invasiva (30 por ciento), a pesar del tratamiento antifúngico. Los 7 pacientes con traqueobronquitis respondieron al tratamiento antifúngico. A pesar de la profilaxis con itraconazol, 3 pacientes (10,3 por ciento) desarrollaron infecciones por Aspergillus spp. Conclusión: La aspergilosis invasiva en el postrasplante inmediato fue mortal a pesar del tratamiento. Contrariamente, las diferentes formas de traqueobronquitis aspergilar se han resuelto con tratamiento combinado con anfotericina B liposomal o lipídica intravenosa, itraconazol y anfotericina nebulizada (AU)
