Kanggo akeh pasien COVID-19 kanthi karusakan paru-paru sing ora bisa dibalekake, transplantasi minangka siji-sijine pilihan kanggo slamet. Nanging, ana informasi winates babagan asil jangka panjang pasien kasebut, kalebu komplikasi pasca operasi, dawane rumah sakit lan kaslametan. Panaliten anyar sing diterbitake ing Journal of the American Medical Association (JAMA) nuduhake asil positif ing 30 pasien COVID-19 berturut-turut pisanan sing ngalami transplantasi paru-paru ing Northwestern Medicine ing Chicago. Asil kanggo pasien transplantasi paru-paru Northwestern Medicine COVID-19 divalidasi dening kertas bebarengan ing New England Journal of Medicine (NEJM) sing nglaporake asil nasional ing pusat transplantasi sing berpengalaman.
Antarane 102 panampa transplantasi paru-paru berturut-turut ing Northwestern Medicine wiwit 21 Januari 2020, nganti 30 September 2021, 30 pasien ditransplantasi amarga COVID-19 lan 72 pasien ditransplantasi amarga penyakit paru-paru tahap pungkasan kronis kalebu cystic fibrosis, hipertensi pulmonal. , fibrosis paru idiopatik lan penyakit paru obstruktif kronis. Sinau JAMA nemokake:
| Pasien COVID-19 | PASIEN NON COVID |
| - 30 pasien ditransplantasikan | - 72 pasien ditransplantasikan |
| - 17 lanang, 13 wadon | - 40 lanang, 32 wadon |
| - Umur Median: 53 | - Umur Median: 62 |
| - Wektu ngenteni: 11.5 dina | - Wektu ngenteni: 15 dina |
| - ECMO digunakake ing 57% pasien | - ECMO digunakake ing 1% pasien |
| - Sajrone transplantasi, pasien nampa a rata-rata 6.5 unit sel getih abang sing dikemas | - Sajrone transplantasi, pasien nampa a rata-rata 0 unit sel getih abang sing dikemas |
| - Wektu operasi rata-rata yaiku 8.5 jam | - Wektu operasi rata-rata yaiku 7.4 jam |
| - Durasi rata-rata rawat inap sawise transplantasi yaiku 28.5 dina | - Durasi rata-rata rawat inap sawise transplantasi yaiku 16 dina |
| - 0% ngembangake penolakan paru-paru | - 12% ngembangake penolakan paru-paru |
| - 100% pasien isih urip ing wektu kasebut artikel JAMA ditulis; kematian saiki tetep ing ndhuwur 90% | - Ing tindak lanjut sawise transplantasi (488 dina median), 83% pasien urip |
"Panaliten iki mbuktekake transplantasi paru-paru efektif banget lan sukses ing pasien COVID-19 sing lara kritis. Kita kaget banget amarga pasien sing nandhang COVID-19 ora nandhang penolakan paru-paru sawise transplantasi, "ujare Ankit Bharat, MD, kepala operasi toraks ing Northwestern Medicine lan direktur eksekutif Canning Thoracic Institute. "Muga-muga transplantasi paru-paru bakal dadi perawatan standar nalika kabeh terapi medis liyane gagal ngrampungake pemulihan paru-paru lan ngilangi pasien saka ventilator lan oksigenasi membran extracorporeal (ECMO), mesin dhukungan urip sing nindakake pakaryan jantung lan paru-paru. . Kita uga ngarep-arep pasien ora ditolak akses menyang intervensi nylametake iki amarga nolak asuransi.
"Kaya sing ditampilake ing panliten kasebut, prosedur transplantasi paru-paru COVID-19 luwih angel lan mbutuhake sumber daya liyane. Prosedur iki mung bakal sukses nalika ditindakake ing pusat transplantasi sing dipilih kanthi pengalaman tingkat dhuwur lan sumber daya sing dibutuhake, "ujare Scott Budinger, MD, kepala kedokteran paru-paru lan perawatan kritis ing Northwestern Medicine lan direktur medis saka Canning Thoracic Institute. "Nalika iki minangka prosedur nylametake, dheweke duwe risiko gedhe. Pasien kudu ngobati obat-obatan sajrone urip lan sanajan mangkono, dheweke bakal nolak paru-paru. Pusat transplantasi kudu milih sapa sing dianggep kanggo prosedur transplantasi paru-paru COVID-19, lan pasien kudu njaluk pendapat liyane nalika nolak transplantasi amarga ora kabeh pusat duwe keahlian kanggo nindakake.
Ing wulan Juni 2020, ahli bedah Northwestern Medicine nindakake transplantasi paru-paru pisanan ing pasien COVID-19 ing Amerika Serikat. Nganti saiki, 40 pasien COVID-19 wis nampa transplantasi paru-paru ing Northwestern Medicine.
APA sing kudu dijupuk saka ARTIKEL INI:
- A new study published in the Journal of the American Medical Association (JAMA) shows positive outcomes in the first 30 consecutive COVID-19 patients who underwent a lung transplant at Northwestern Medicine in Chicago.
- “We hope lung transplantation will become a standard treatment of care when all other medical therapies fail to achieve lung recovery and get the patients off the ventilator and extracorporeal membrane oxygenation (ECMO), a life support machine that does the work of the heart and lungs.
- The outcomes for Northwestern Medicine COVID-19 lung transplant patients are validated by a concurrent paper in New England Journal of Medicine (NEJM) which reports national outcomes at experienced transplant centers.
