Türkiye’de akciğer nakli için donör seçimi: İdeal bir donör beklemek gerekir mi?
Amaç: Bu çalışmada kliniğimizde akciğer naklinde kullanılan donör kriterleri değerlendirildi. Çalışma planı: Aralık 2016 - Ocak 2019 tarihleri arasında kliniğimizde akciğer nakli için kabul edilen toplam 55 kadaverik donör ideal donör kriterlerine göre geriye dönük olarak değerlendirildi. Donörler yaşlarına, arteriyel kandaki kısmi oksijen basıncına, sigara öyküsüne ve ventilasyon gününe göre ideal ve ideal olmayanlar olmak üzere iki gruba ayrıldı. Donör verileri, alıcı özellikleri ve sağkalım sonuçları değerlendirildi. Bulgular: Akciğer nakli için kabul edilen 55 donörün 24'ü (%43.7) ideal ve 31'i (%56.3) ideal olmayan dönörler idi. Doksan günlük mortalite ve bir yıllık sağkalım oranları açısından iki grup arasında anlamlı bir fark yoktu. Doksan günlük mortalite ideal grupta %25 iken, ideal olmayan grupta %22.6 idi (p=0.834). Akciğer naklinden sonraki bir yıllık sağkalım oranı, ideal ve ideal olmayan gruplarda sırasıyla %64.5 ve %70.6 idi (p=0.444). Sonuç: Akciğer nakli için donörleri kabul etmeden veya reddetmeden önce tüm klinik tablo değerlendirilmelidir. İdeal kriterleri karşılamayan akciğer donörlerinin kullanılması, ideal akciğer donörleri ile karşılaştırıldığında, kısa ve orta vadeli sonuçları bozmaz. Donör kriterlerinin sıkı uygulanması, akciğer nakli için uygun donörlerin kullanılmasını engelleyebilir. İdeal olmayan donörlerin kullanılması bekleme listesi mortalitesini azaltabilir
Donor selection for lung transplant in Turkey: Is it necessary to wait for an ideal donor?
Background: The aim of this study was to evaluate the donor criteria used in lung transplantation in our clinic. Methods: A total of 55 cadaveric donors who were accepted for lung transplantation in our clinic between December 2016 and January 2019 were retrospectively analyzed according to ideal donor criteria. The donors were divided into two groups as ideal and non-ideal ones according to their age, partial pressure of oxygen in arterial blood, history of smoking, and ventilation day. Donor data, recipient characteristics and survival outcomes were evaluated. Results: Of 55 donors accepted for lung transplantation, 24 (43.7%) were ideal and 31 (56.3%) were non-ideal donors. The 90-day mortality and one-year survival rates were not significantly different between the two groups. The 90-day mortality was 25% in the ideal group and 22.6% in the non-ideal group (p=0.834). The one-year survival rates after lung transplantation were 64.5% versus 70.6% in the ideal and non-ideal groups, respectively (p=0.444). Conclusion: The whole clinical picture should be evaluated before accepting or rejecting donors for lung transplantation. The use of lung donors that do not meet the ideal criteria does not impair short- and mid-term results, compared to ideal lung donors. Strict implementation of donor criteria may prevent using suitable donors for lung transplantation. Use of non-ideal donors can reduce waiting list mortality.
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