流した臓器に公平なところはない. 30日間の配列外配分を排除すると,入れ替えが難しい腎臓の利用が減る
Christopher Curran1, Jillian Wojtowicz1, James R Rodrigue2
1New England Donor Services.
まとめ
死んだドナーの腎臓の配分を順番外 (AOOS) に停止した救助経路は,特に高KDPIの臓器の非使用を14%増加させた. これは,腎臓の利用を改善するために,定義された国家救済配分戦略の必要性を強調しています.
科学分野:
- 移植免疫学について
- 臓器調達 臓器調達について
- ネフロロジーはネフロロジーを用います.
背景:
- 配列外配分 (AOOS) は,使用不可能なリスクのある死去したドナーの腎臓を活用する戦略です.
- 整体腎臓利用に対するAOOSの影響は,移植コミュニティ内での議論の対象であり続けています.
研究 の 目的:
- AOOSの救助経路を一時的に停止することで,亡くなったドナーの腎臓の利用に及ぼす影響を評価する.
- AOOSのない期間に腎臓の非使用率の変化を評価する.
主な方法:
- 将来の単一臓器調達機関 (OPO) の実証プロジェクトが実施されました.
- AOOSの救助経路は30日間停止され,腎臓は全国的なマッチランの配列によって厳格に割り当てられました.
- 介入中の腎臓の利用は,12ヶ月の基準期間と比較した.
主要な成果:
- 全体的に腎臓の非使用は介入期間中に29.1%から43.2%に増加しました.
- より高い腎臓ドナープロフィール指数 (KDPI) の腎臓の非使用率が高く見られた.
- 推定13人の腎臓が移植され,使用率が基準期間と一致していたら,さらに13人の腎臓が移植されていただろう.
結論:
- AOOS救助経路の一時的な停止は,特に医学的に複雑な腎臓の場合は,腎臓の非使用の有意な増加と関連していました.
- 標準化された代替手段なしに救助の割り当てを排除すると,臓器の浪費が増加する可能性があります.
- 透明で国家的に定義された救助配分戦略は,亡くなったドナーの腎臓の利用を最適化するために不可欠です.
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