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肺部被拒绝移植的评估以及对供体选择的影响
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
概括
许多适合移植的捐赠肺被拒绝. 一项研究发现,41%的被拒绝的肺部符合标准,强调需要更好的供体肺部选择方案.
科学领域:
- 肺部病理学 肺部病理学
- 移植医学 移植医学
- 胸部外科手术 胸部外科手术
背景情况:
- 目前的供体肺选标准导致超过85%的可用肺被排除在外.
- 这种高排斥率引发了人们对肺部移植可活性的器官潜在不足利用的担忧.
研究的目的:
- 为了调查是否有潜在的合适的供体肺被拒绝移植.
- 通过使用综合评估方法,评估被拒绝的供体肺的生存能力.
主要方法:
- 获取和评估29对被拒绝的供体肺部.
- 利用生理学,微生物学和组织学评估技术.
- 在适合性评估中考虑了微生物学和非肺捐赠者的特定因素.
主要成果:
- 绝大多数被排斥的肺部显示出极少或没有肺 (83%).
- 大多数肺部表现出完整的膜液清除率 (74%) 和正常或轻微异常的组织结构 (62%).
- 在全面审查后,被拒绝的肺部中有41% (12对中的29对) 被认为可能适合移植.
结论:
- 很大一部分被拒绝的供体肺部具有适合移植的特征.
- 迫切需要对当前供体肺选标准进行前性科学评估.
- 优化供体肺的选择可以增加器官的可用性,并改善肺移植的结果.
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