Akciğer Nakli Cerrahi Süreci
Özet
Akciğer nakli, solid organ nakilleri arasında en riskli ve en az yapılan nakil olmasına rağmen tedavilere yanıt vermeyen akciğer yetmezliğinin tedavisi için tek seçenektir. Son 40 yılda hem tıbbi gelişmelerin hem de nakil ekiplerinin multidisipliner gelişimlerinin etkisi ile özellikle son iki dekatta başarılı bir şekilde uygulanmakta ve diğer organ nakillerine benzer sağkalım oranlarına ulaşmaktadır. Bu gelişimin temelindeki ana etkenler uygun alıcı ve donör seçimi, nakil öncesi ve sonraki dönemde ekiplerin iletişim ve tedavilerde deneyim kazanmasına ek olarak tedavi ve teknolojideki ilerlemelerdir. Bu bölümün amacı, akciğer nakli endikasyon ve kontrendikasyonları, uygun donör ve alıcı seçimi ile hazırlanması ve cerrahi sürecin anlatılmasıdır.
Referanslar
Christie JD, Edwards LB, Aurora P, et al. The Registry of the International Society for Heart and Lung Transplantation: Twenty-sixth Official Adult Lung and Heart-Lung Transplantation Report—2009. J Heart Lung Transplant.
Valapour M, Lehr CJ, Skeans MA, et al. OPTN/SRTR 2019 Annual Data Report: Lung. Am J Transplant. 2021;21(S2):427-504.
Weill D, Benden C, Corris PA, et al. A consensus document for the selection of lung transplant candidates: 2014--an update from the Pulmonary Transplantation Council of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant 2015;34:1.
Orens JB, Boehler A, de Perrot M, Estenne M, Glanville AR, Keshavjee S, Kotloff R, Morton J, Studer SM, Van Raemdonck D, Waddel T, Snell GI; Pulmonary Council, International Society for Heart and Lung Transplantation. A review of lung transplant donor acceptability criteria. J Heart Lung Transplant. 2003 Nov;22(11):1183-200. doi: 10.1016/s1053-2498(03)00096-2.
Department of Health and Human Services, Health Resources and Services Administration, Office of Special Programs, Division of Transplantation 2000 annual report of the U.S. Scientific Registry for transplant recipients and the organ procurement and transplantation network. UNOS, Washington, DC2000
Luckraz H, White P, Sharples LD, Hopkins P, Wallwork J. Short- and long-term outcomes of using pulmonary allograft donors with low Po2. J Heart Lung Transplant. 2005 Apr;24(4):470-3. doi: 10.1016/j.healun.2004.02.012.
Whitford H, Kure CE, Henriksen A, Hobson J, Snell GI, Levvey BJ, Marasco SF, Gooi JH, Zimmet A, Negri J, Pick A, Buckland M, Williams T, Westall G, Paraskeva MA, Martin C, McGiffin DC. A donor PaO2/FiO2 < 300 mm Hg does not determine graft function or survival after lung transplantation. J Heart Lung Transplant. 2020 Jan;39(1):53-61. doi: 10.1016/j.healun.2019.08.021.
McCowin MJ, Hall TS, Babcock WD, Solinger LL, Hall KW, Jablons DM. Changes in radiographic abnormalities in organ donors: associations with lung transplantation. J Heart Lung Transplant. 2005 Mar;24(3):323-30. doi: 10.1016/j.healun.2003.10.025.
Low DE, Kaiser LR, Haydock DA, Trulock E, Cooper JD. The donor lung: infectious and pathologic factors affecting outcome in lung transplantation. J Thorac Cardiovasc Surg. 1993 Oct;106(4):614-21.
Referanslar
Christie JD, Edwards LB, Aurora P, et al. The Registry of the International Society for Heart and Lung Transplantation: Twenty-sixth Official Adult Lung and Heart-Lung Transplantation Report—2009. J Heart Lung Transplant.
Valapour M, Lehr CJ, Skeans MA, et al. OPTN/SRTR 2019 Annual Data Report: Lung. Am J Transplant. 2021;21(S2):427-504.
Weill D, Benden C, Corris PA, et al. A consensus document for the selection of lung transplant candidates: 2014--an update from the Pulmonary Transplantation Council of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant 2015;34:1.
Orens JB, Boehler A, de Perrot M, Estenne M, Glanville AR, Keshavjee S, Kotloff R, Morton J, Studer SM, Van Raemdonck D, Waddel T, Snell GI; Pulmonary Council, International Society for Heart and Lung Transplantation. A review of lung transplant donor acceptability criteria. J Heart Lung Transplant. 2003 Nov;22(11):1183-200. doi: 10.1016/s1053-2498(03)00096-2.
Department of Health and Human Services, Health Resources and Services Administration, Office of Special Programs, Division of Transplantation 2000 annual report of the U.S. Scientific Registry for transplant recipients and the organ procurement and transplantation network. UNOS, Washington, DC2000
Luckraz H, White P, Sharples LD, Hopkins P, Wallwork J. Short- and long-term outcomes of using pulmonary allograft donors with low Po2. J Heart Lung Transplant. 2005 Apr;24(4):470-3. doi: 10.1016/j.healun.2004.02.012.
Whitford H, Kure CE, Henriksen A, Hobson J, Snell GI, Levvey BJ, Marasco SF, Gooi JH, Zimmet A, Negri J, Pick A, Buckland M, Williams T, Westall G, Paraskeva MA, Martin C, McGiffin DC. A donor PaO2/FiO2 < 300 mm Hg does not determine graft function or survival after lung transplantation. J Heart Lung Transplant. 2020 Jan;39(1):53-61. doi: 10.1016/j.healun.2019.08.021.
McCowin MJ, Hall TS, Babcock WD, Solinger LL, Hall KW, Jablons DM. Changes in radiographic abnormalities in organ donors: associations with lung transplantation. J Heart Lung Transplant. 2005 Mar;24(3):323-30. doi: 10.1016/j.healun.2003.10.025.
Low DE, Kaiser LR, Haydock DA, Trulock E, Cooper JD. The donor lung: infectious and pathologic factors affecting outcome in lung transplantation. J Thorac Cardiovasc Surg. 1993 Oct;106(4):614-21.
