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移植を拒否された肺の評価と,ドナーの選択への影響
Lorraine B Ware1, Yibing Wang, Xiaohui Fang
1Division of Allergy, Pulmonary, and Critical Care, Department of Medicine, Vanderbilt University School of Medicine, T1217 MCN, Nashville, TN 37232-2650, USA. lorraine.ware@vanderbilt.edu
Lancet (London, England)
|September 21, 2002
まとめ
移植に適した多くのドナー肺は拒絶されます. ある研究によると,拒絶肺の41%が基準を満たしており,より良いドナー肺選択プロトコルの必要性を強調しています.
科学分野:
- 肺病理学 肺病理学とは
- 移植医療 移植医療について
- 胸部外科手術について
背景:
- 現在のドナー肺の選択基準では,利用可能な肺の85%以上が排除されています.
- この高い排除率は,肺移植のための活力のある臓器の潜在的未使用に関する懸念を高めています.
研究 の 目的:
- 潜在的に適切なドナー肺が移植のために拒絶されているかどうかを調査する.
- 総合的な評価方法を使用して,拒絶されたドナーの肺の生存可能性を評価する.
主な方法:
- 29組の拒絶されたドナー肺の取得と評価.
- 生理学的,微生物学的,および組織学的評価技術を活用した.
- 適性評価において考慮された微生物学的および非肺ドナー特異的要因.
主要な成果:
- 拒絶肺の大多数は,肺腫がほとんどないか全くない (83%) でした.
- ほとんどの肺は,無傷な肺膜液クリアランス (74%) と正常または軽く異常なヒストロジー (62%) を示した.
- 総合的なレビューの結果,拒絶された肺の41% (12対の29組) が移植に適している可能性があると判断されました.
結論:
- 拒絶されたドナーの肺の大部分は,移植に適した特徴を持っています.
- 現在のドナー肺選択基準の将来的な科学的評価が緊急に求められている.
- ドナー肺の選択を最適化することで,臓器の可用性を高め,肺移植の結果を改善することができます.
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