First Chinese National Registry Report of Lung Transplantation in 2016

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Abstract

Background

Voluntary organ donation after death of citizens has become the sole source of organ transplant in Mainland China. The Chinese lung transplant registry was supported by National Health and Family Planning Commission. Hererin, the objective of the study was to present the first national report of Chinese lung transplant registry.

Methods

The Chinese registry for lung transplant is a prospective registry designed to import all information of transplant and control quality of the procedure nationally. Data from the Chinese lung transplantation registry were analyzed. The study cohort included lung transplants performed and reported to Registry in 2016. The participating institutions included 11 centers in China. All the lung transplants were approved by the Ethics Committee of transplant.

Results

A total of 176 donors donated their lungs, including 98 (55.68%) cases of donation after brain and cardiac death(DBCD),65 (36.93%) donation after brain death, and 13 (7.39%) donation after cardiac death(DCD).The mean age for these donors were 31.65 (16-47)years old, with a mean ventilation time of 4.36(1-15) days in the intensive care unit. There were 202 lung transplants performed during the study period, including 198 cases of primary lung transplants and 4 cases of secondary transplants,75 patients received bilateral lung transplant, 42 with left single lung transplant,64 with right single lung transplant, 2 lobar transplants, and 3 with heart-lung transplants. The mean age of recipients was 53.22 (16-75) years old, with 162 males (82.23%). In this cohort, 36.41% of the indications were idiopathic pulmonary fibrosis, 21.20% were chronic obstructive pulmonary disease, 9.78% were silicosis, 4.89% bronchiectasis, 2.72% lymphangioleiomyomatosis,et al.Extracorporeal membrane oxygenation(ECMO) was used in 68.49% of the patients. The median ICU stay time was 4 days(IQR:3-6days), 36 days for hospitalization (IQR:14-69days). There were 25 deaths during perioperative period, including 13 cases of sepsis and 12 primary graft dysfunction. Early postoperative complications included infections (77.02%), primary graft dysfunction (22.09%), diabetes mellitus(10.14%),renal insufficiency (9.52%), acute rejection (9.43%), hypertension(4.76%), airway complications (4.55%), and vascular anastomotic complications (2.03%). Unifactor logistic regression analysis for showed female recipients, type O blood, preoperative ICU stay,preoperative immobility,poor 6-minute walking test,bilateral lung transplantation,and PGD were risk factors for mortality in hospital(P <0.05),with ORs of 2.67(95%CI:1.02-6.96), 2.48(95%CI:1.04-5.91),5.66(95%CI:1.88-17.07),2.56(95%CI:1.03-6.34),3.20(95%CI:1.19-8.62),3.20(95%CI:1.32-7.77),and 4.05(95%CI:1.66-9.88),respectively.

Conclusion

Establishment of Chinese registry for lung transplant facilitated national control of this procedure with good quality,which requires verification and improvement in future.

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