Características clínicas y funcionales antes del trasplante pulmonar. Experiencia en la Clínica Puerta de Hierro

Resultados En el período estudiado se realizaron 100 trasplantes pulmonares. La edad media de los pacientes era de 45 años (rango: 15-67) y el 57% eran varones. Las enfermedades que con mayor frecuencia motivaron el trasplante pulmonar fueron la enfermedad pulmonar obstructiva crónica (EPOC, 35%), la fibrosis pulmonar (29%) y las bronquiectasias (BQ) (21%). La media ± desviación estándar de la función pulmonar osciló entre el 20 ± 11% del volumen espiratorio forzado en el primer segundo (FEV 1 ) y el 37 ± 15% de la capacidad vital forzada (FVC) en la EPOC; del 41 ± 15% del FEV 1 y el 40 ± 17% de la FVC en la fibrosis pulmonar, y del 23 ± 7% del FEV 1 y el 37 ± 10% de la FVC en las BQ. Conclusiones Los pacientes que recibieron un trasplante pulmonar en nuestro centro se encontraban en fases muy evolucionadas de su enfermedad y cumplían los criterios de inclusión admitidos por las diferentes sociedades médicas cuando se les incluyó en lista de espera. Objective The time at which lung transplantation is indicated is determined by clinical and functional criteria that vary according to the particular disease. The aim of our study was to present the criteria according to which patients were placed on waiting lists for lung transplantation in our hospital. Patients and methods We analyzed retrospectively the clinical characteristics, lung function, heart function, and 6-minute walk test results of patients who had received a lung transplant in our hospital from January 2002 through September 2005. Results During the study period 100 lung transplants were performed. The mean age of the patients was 45 years (range, 15-67 years) and 57% were men. The diseases that most often led to a lung transplant were chronic obstructive pulmonary disease (COPD) (35%), pulmonary fibrosis (29%), and bronchiectasis (21%). Lung function values differed by disease: mean (SD) forced expiratory volume in 1 second (FEV 1 ) was 20% (11%) and forced vital capacity (FVC) was 37% (15%) in patients with COPD; FEV 1 was 41% (15%) and FVC, 40% (17%) in patients with pulmonary fibrosis; and FEV 1 was 23% (7%) and FVC, 37% (10%) in patients with bronchiectasis. Conclusions The patients who received lung transplants in our hospital were in advanced phases of their disease and met the inclusion criteria accepted by the various medical associations when they were placed on the waiting list. Palabras clave Trasplante pulmonar Enfermedad pulmonar Espirometría Selección de pacientes Key words Lung transplantation Lung disease Spirometry Selection of patients Bibliografía 1. A. Salvatierra Velázquez Trasplante pulmonar en España Arch Bronconeumol 40 Supl 6 2004 41 48 2. J.M. Borro Actualización del trasplante pulmonar en España Arch Bronconeumol 41 2005 457 467 3. J.B. Orens M. Estenne S. Arcasoy J.V. Conte P. Corris J.J. 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