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根据2018年心脏分配系统,在同时进行心脏移植时,改善了等待列表和可比的移植后结果
Yeahwa Hong1, Nicholas R Hess2, Luke A Ziegler2
1Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa.
The Journal of thoracic and cardiovascular surgery
|July 22, 2023
概括
2018年心脏分配政策变化改善了同时心脏移植等候名单的结果,减少了等待时间和增加了移植率. 在政策更新后,早期移植后的存活率仍然相当.
科学领域:
- 移植医学 移植医学
- 器官分配政策 器官分配政策
- 心血管外科心血管外科
背景情况:
- 同时心脏移植 (SHKT) 是一种复杂的手术,适用于末期心脏和脏疾病的患者.
- 2018年器官分配政策更新旨在优化器官分配和患者的结果.
- 评估政策变化对SHKT的影响对于完善分配策略至关重要.
研究的目的:
- 在2018年美国心脏分配政策变化之前和之后评估SHKT的临床趋势.
- 分析政策变化对SHKT等候名单结果和移植后存活率的影响.
- 确定与2018年SHKT分配系统相关的风险调整后死亡率.
主要方法:
- 对于成年SHKT患者的联合器官共享网络登记册的回顾性分析.
- 在2018年政策变化之前和之后等候名单和移植后结果的比较.
- 多变量分析以评估等待名单和移植后死亡率的风险.
主要成果:
- 2018年的政策变化导致了SHKT费率的提高,等候名单时间缩短,并降低了退市的可能性.
- 移植后的结果,包括90天,6个月和1年的生存率和并发症率,在政策变化之前和之后都是可比的.
- 2018年分配系统显著降低了风险调整后1年等候名单死亡率,但没有显著影响1年移植后死亡率.
结论:
- 2018年心脏分配政策通过改进等待列表指标来增强SHKT.
- 在SHKT之后的早期移植后存活率保持一致,尽管政策修改.
- 政策更新表明对等待名单死亡率产生积极影响,强调其对等待双器官移植的患者的好处.
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