在循环死亡后,移植结果与捐赠者心脏
Jacob N Schroder1, Chetan B Patel1, Adam D DeVore1
1From Duke University Medical Center, Durham, NC (J.N.S., C.B.P., A.D.D., S.C., C.A.M.); Northwestern University (B.S.B., D.T.P.) and the University of Chicago (C.T.S.) - both in Chicago; Vanderbilt University Medical Center, Nashville (A.S., T.A.); University of Wisconsin Hospital and Clinics, Madison (J.W.S.), and the Medical College of Wisconsin, Milwaukee (D.L.J.); the University of California, San Francisco, San Francisco (A.G.F.), the University of California, San Diego, La Jolla (V.P.), Cedars-Sinai Medical Center, Los Angeles (F.E.), and Stanford University Medical Center, Stanford (Y.S.) - all in California; Emory University Hospital, Atlanta (M.D., T.S.A.); Advent Health, Orlando (S.S.), Mayo Clinic, Jacksonville (S.M.P.), and Tampa General Hospital, Tampa (J.D., L.L.) - all in Florida; Yale School of Medicine, New Haven, CT (A.G.); Nebraska Medical Center, Omaha (J.Y.U.); Columbia University Medical Center, New York (K.T.), Montefiore Medical Center, Bronx (D.J.G.), and Westchester Medical Center, Valhalla (M.K.) - all in New York; Minneapolis Heart Institute Foundation (K.M., B.S., B.C.S.) and the University of Minnesota Medical Center (A.W.S.) - both in Minneapolis; Sentara Norfolk General Hospital, Norfolk (J.P.), and Virginia Commonwealth University, Richmond (M.A.Q.) - both in Virginia; Tufts Medical Center (G.S.C.), Brigham and Women's Hospital (H.R.M., M.M.G., M.R.M.), and Massachusetts General Hospital (J.C.M., D.A.D.) - all in Boston; and the University of Texas Southwestern Medical Center, Dallas (M.F.).
血液循环死亡 (DCD) 后捐赠者的心脏显示了与心脏移植中脑死亡 (DBD) 后捐赠者的6个月生存率相似的情况. 这项研究表明,DCD心脏是一种安全有效的替代方案,扩大了等待移植的患者的捐赠选择.
科学领域:
- 心血管外科心血管外科
- 移植医学 移植医学
- 供体器官的利用情况
背景情况:
- 关于心脏移植使用循环死亡 (DCD) 后的捐赠者与脑死亡 (DBD) 后的捐赠者之间的疗效和安全性的数据有限.
- 扩大捐赠心脏来源对于解决心脏移植中器官短缺至关重要.
研究的目的:
- 为了比较心脏移植的有效性和安全性,使用DCD捐赠者与DBD捐赠者.
- 评估DCD与DBD心脏接收者的6个月生存率和严重不良事件.
主要方法:
- 一个随机的,非劣势性试验,比较DCD捐赠者 (使用体外输液) 与标准DBD捐赠者 (使用冷藏) 的心脏移植.
- 成年心脏移植候选人被分配到DCD或DBD组,比例为3:1.
- 主要终点:风险调整后的6个月生存期;次要终点:移植后30天发生的严重不良事件.
主要成果:
- 风险调整后的6个月生存率在DCD组为94%,而DBD组为90%,表明非劣势 (P<0.001).
- 在30天内,DCD和DBD组之间没有观察到与心脏移植相关的严重不良事件的显著差异.
- 这项研究包括166名移植接受者在初级分析中 (80 DCD,86 DBD).
结论:
- 使用DCD捐赠者心脏的心脏移植被复活并通过体外输液进行评估,与标准的DBD心脏移植无差.
- 这种方法扩大了捐赠者库,为心脏移植接受者提供了安全有效的替代方案.
相关概念视频
Kidney Transplant I: Introduction
Tissue Transplantation
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...


