42.有關肺臟移植之敘述,下列何者錯誤?
(A)5年存活率>50%
(B)術後3個月內最常見之感染為病毒感染
(C)依據世界心肺移植登記,最常見接受移植的診斷為阻塞性肺病
(D)免疫抑制藥物需終身服用

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統計: A(63), B(223), C(63), D(30), E(0) #1741811

詳解 (共 2 筆)

#3988995
Egans P.524、P.582

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#4174424

補充併發症時機

immediate and early postoperative period (first 24 hours to first week)

  • malpositioned tubes and lines
  • mechanical problems due to size mismatching between the donor lungand  the recipient thoracic cage
  • primary graft dysfunction - pulmonary edema following lung     transplantation (reimplantation response)
  • corresponds to a transient ischemic/reperfusion injury that appears as a  pulmonary edema in almost every patient during the first three days  post-  Surgery
  • acute lung transplant rejection
  • common process in the first 2 weeks after transplant with good prognosis
  • hyperacute lung transplant rejection
  • fulminant syndrome that occurs immediately after the transplant and has a  poor prognosis
  • pleural complications
  • pneumothorax
  • hemothorax
  • pleural effusion
  • pleural fistula

intermediate period (1 week to 4 months)

  • acute lung transplant rejection
  • anastomotic (airway) dehiscence
  • airway stenosis
  • Candida infection: first 3 months
  • CMV infection: between 1 and 6 months
  • Aspergillus infection: between 1 and 6 months
  • pulmonary artery stenosis

late periods (after 4 months)

  • Mycobacterial Infection
  • RSV infection
  • chronic lung allograft dysfunction (CLAD)
  • bronchiolitis obliterans is probably due to chronic rejection
  • upper lobe fibrosis is probably due to rejection
  • post-transplant lymphoproliferative disorder

4174424-62617b2247fb1.jpg

Current 1-, 5-, and 10-year survival rates following lung transplantation are 82%, 55%, and 33%,

Mortality is highest during the first year, with primary graft dysfunction and infection representing the most common causes of death.


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