目前的器官共享联合网络心脏分配系统面临的挑战
Timothy A Gong1,2,3, Shelley A Hall1,2,3
1Center for Advanced Heart and Lung Disease, Baylor Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center.
Current opinion in organ transplantation
|August 18, 2023
概括
2018年心脏移植分配系统改善了等待时间,但存活率结果不尽相同. 未来的系统需要更好的风险分层和对例外请求的监督.
科学领域:
- 心脏病学 心脏病学
- 移植医学 移植医学
- 卫生政策 卫生政策
背景情况:
- 美国器官共享联合网络 (UNOS) 在2018年10月修订了美国的心脏器官分配系统.
- 这一政策变化旨在优化器官分配,改善患者的治疗结果.
研究的目的:
- 审查修订的UNOS心脏器官分配政策.
- 描述新政策的预期和非预期后果.
主要方法:
- 在2018年政策变化之后,审查最近的出版物和数据.
- 对心脏移植后的存活率,等候名单时间,缺血时间和左心室辅助器件 (LVAD) 使用率的分析.
主要成果:
- 最初对移植后6个月和1年的生存率下降的担忧已经被长期数据所缓解,这些数据显示了可比的生存率.
- 整体等待列表的时间从112天大幅减少到39天.
- 尽管政策发生了变化,但约有30%的患者仍在例外状态下等候名单上,LVAD植入物已下降.
结论:
- 修订后的分配系统成功地减少了等待列表的时间.
- 需要进一步改进,以改善风险分层,监督例外请求,并解决持久LVADs的作用.
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