生命至上,尊重科学——中国肺移植发展现状及展望述评

Life first and science respect: A commentary on current status and expectations of China’s lung transplantation

肺移植是治疗终末期肺病的唯一有效方法,肺移植在全世界取得快速的发展,目前每年约开展4 000例,长期生存率逐步提高。中国肺病高发,每年至少有上万名呼吸衰竭的病人需要接受肺移植手术,2020年我国29个肺移植中心开展超过500台肺移植手术。我国肺移植受者排名靠前的原发病依次为特发性肺间质纤维化、慢性阻塞性肺疾病及继发性肺间质纤维化和尘肺,单、双肺移植分别占比57.6%和42.4%,受者术后围手术期(<30 d)、1年、3年生存率分别为78.5%、64.5%、48.9%(双肺移植)和83.0%、69.9%、46.8%(单肺移植)。在2020年新型冠状病毒肺炎疫情期间,武汉大学人民医院完成了湖北省首例新型冠状病毒肺炎肺移植手术,术后患者顺利康复出院。尽管我国肺移植取得很大的进步,但仍需认识到多学科团队协作模式及数据注册管理工作仍需进一步加强,以期提供更多的临床相关指南和共识,使各肺移植中心稳步发展提高,逐渐推动中国的肺移植进入世界器官移植舞台的中央。

Lung transplantation is the only effective method for the treatment of end-stage lung diseases.Lung transplantation has achieved rapid development in the world.At present, about 4 000 cases are carried out every year, and the long-term survival rate has gradually improved.With a high incidence of lung disease in China, at least ten thousand patients with respiratory failure need lung transplantation every year.In 2020, 29 lung transplantation centers in China has carried out more than 500 cases of lung transplantation.Idiopathic pulmonary interstitial fibrosis, chronic obstructive pulmonary disease, secondary pulmonary interstitial fibrosis and pneumoconiosis were the main primary diseases in lung transplantation recipients in China.Single-lung transplantation accounted for 57.6% and double-lung transplantation accounted for 42.4%, respectively.Peri-operation(<30 days), one-year, and three-year survival rates were 78.5%, 64.5% and 48.9%, respectively for double-lung transplant.The corresponding survival rates for single-lung transplant recipients were83.0%, 69.9% and 46.8%, respectively.The Renmin Hospital of Wuhan University completed the first case of COVID-19 lung transplantation operation in Hubei Province in 2020, and the patients recovered and discharged successfully after the operation.Although China has made great progress in lung transplantation, it is still necessary to realize that the multi-disciplinary team cooperation mode and data registration management still need to be further strengthened, in order to provide more clinical guidelines and expert consensus and make the steady development and improvement of each lung transplantation center.The lung transplantation in China will be gradually promoted to the center of the organ transplantation stage in the world.