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在引入MELD得分之前和之后,肝移植的差异

Cynthia A Moylan¹, Carla W Brady, Jeffrey L Johnson

¹Division of Gastroenterology, Duke University Medical Center, PO Box 3913, Durham, NC 27710, USA. moyla003@mc.duke.edu

|November 27, 2008

概括

末期肝病模型 (MELD) 评分改善了黑人患者的肝移植机会,消除了种族差异. 然而,与男性相比,女性在接受肝移植时仍然面临着显著的劣势.

科学领域:

肝病学肝病学是一种肝病学.
移植医学移植医学
医疗服务研究医疗服务研究

背景情况:

末期肝病模型 (MELD) 评分于2002年2月实施,用于分配肝脏器官.
在MELD之前,黑人患者在肝移植等待名单上的结果比白人患者差.
关于获得肝移植的性别差异的数据有限.

研究的目的:

检查MELD得分对黑人患者和女性肝移植机会的影响.
为了确定种族和性别是否影响MELD实施后的肝移植结果.

主要方法:

对肝移植等候名单患者 (1996-2006) 的回顾性队列研究.
比较MELD前 (1996-2000) 和MELD后 (2002-2006) 的队列.
分析了种族,性别,死亡和肝移植接收在3年内之间的关联.

主要成果:

在MELD后,种族不再是肝移植获得或等待名单死亡率的重要因素.
黑人患者在MELD前后期间都比白人患者年轻,病情更严重.
与男性相比,女性的肝移植率较低,死亡率/不适合性较高,无论是在MELD之前还是之后.

结论:

在肝移植中,MELD得分有效地减少了种族差异.
尽管使用了MELD系统,但肝移植获取和结果的性别差异仍然存在.
需要进一步的研究来解决肝移植中基于性别的不平等问题.

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