肺移植中的捐赠者:年龄是否重要?
Charlotte Ponte1,2,3, Omar Alkhatiri1,3, Anne Olland1,2,3
1Hôpitaux Universitaire de Strasbourg, Service de chirurgie thoracique-Nouvel Hôpital Civil, Strasbourg, France.
概括
使用老年捐赠肺 (>60岁) 的肺移植可以与年轻捐赠肺产生相似的结果. 精心选择接受者,特别是慢性阻塞性肺病 (COPD) 患者,是成功进行肺移植的关键.
科学领域:
- 移植免疫学 移植免疫学
- 胸部外科手术 胸部外科手术
- 供体器官的利用情况
背景情况:
- 肺移植是末期呼吸道疾病的拯救性手术.
- 鉴于器官短缺,优化捐赠器官利用率至关重要.
- 捐赠者的年龄对肺移植结果的影响需要仔细评估.
研究的目的:
- 为了确定60岁以上的捐赠者的肺移植与60岁或更年轻的捐赠者的移植相比,是否与同等的结果有关.
- 分析结果,包括初级移植功能障碍,呼吸功能和肺移植接受者的生存.
主要方法:
- 进行了最好的证据系统审查.
- 一项全面的文献搜索发现了200多篇相关论文.
- 十二篇高质量的论文构成了回答临床问题的基础.
主要成果:
- 存活结果因供体年龄被分析为原始或根据接受者因素进行调整而有所不同.
- 患有间歇性肺病 (ILD),肺高血压或囊性纤维化 (CF) 的接受者表现出较老的捐赠肺的生存率较低.
- 虽然一些研究表明1秒内强迫呼气量 (FEV1) 更差,但在某些情况下,初级移植功能障碍率相似.
结论:
- 从60岁以上的捐赠者获得的肺移植,当仔细评估和分配时,可以提供与年轻的捐赠者肺部相似的结果.
- 特定的接受者群体,如慢性阻塞性肺病 (COPD) 患者,可能会从较老的捐赠肺中获益最多,特别是如果不需要长期心肺绕道 (CPB).
相关概念视频
Kidney Transplant I: Introduction
29
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
29
Tissue Transplantation
415
Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
415
Kidney Transplant II: Surgical Procedure
36
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
36
Bone Marrow Sampling and Transplants
363
Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
363


