循环死亡后的捐赠:移植心脏病学家对神经预测的看法
Melissa A Lyle1, Stephen W English2, Rohan M Goswami1
1Division of Advanced Heart Failure and Transplantation, Department of Transplantation, Mayo Clinic, Jacksonville, Florida.
概括
循环死亡 (DCD) 心脏移植后的捐赠正在增长,但缺乏标准化的神经预测和功能性温暖缺血时间 (fWIT) 评估. 为了更好的供体选择和器官利用,需要呼吁制定标准化方法.
科学领域:
- 心脏病学 心脏病学
- 移植手术 移植手术
- 器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器
背景情况:
- 循环死亡 (DCD) 后的捐献正在扩大心脏移植的捐献人群.
- 目前的DDC供体选择在标准化神经预测和功能热缺血时间 (fWIT) 评估方面面临挑战.
- 关于纳入神经学检查和可接受的fWIT值存在缺乏共识.
研究的目的:
- 突出移植心脏病专家在DCD心脏捐献的神经预测方面所面临的挑战.
- 倡导在DCD供体选择中开发标准化的方法.
- 改善DCD心脏移植的资源配置和器官利用.
主要方法:
- 本视角讨论了DCD供体选择当前的做法和挑战.
- 它审查了现有的评分系统及其局限性.
- 它强调了对神经预测和fWIT测量的更标准化的方法的需要.
主要成果:
- 在预测捐赠者到期时间方面,显著缺乏标准化.
- 目前的评分系统有其局限性,包括需要切断呼吸器支或省略神经学评估.
- 不同的DCD器官移植在特定的时间窗口中存在差异,没有明确的理由.
结论:
- 标准化的神经预测和fWIT评估对于DCD心脏移植至关重要.
- 需要采用统一的方法来应对DCD供体选择中的挑战.
- 改进标准化将提高器官利用率和心脏捐献的资源配置.
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