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肺移植中增加风险与标准风险捐赠:一个联合器官共享网络的分析分析
Meredith Brown1, Mohammed Abul Kashem1, Huaqing Zhao1
1Division of Cardiovascular Surgery, Department of Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pa.
The Journal of thoracic and cardiovascular surgery
|September 9, 2023
概括
来自高风险献血者 (IRD) 的肺移植显示出与标准风险献血者 (SRD) 相似的生存结果. 使用IRD可以安全地扩大捐赠者池,增加移植受体的肺部可用性.
科学领域:
- 移植免疫学 移植免疫学
- 公共卫生 公共卫生
- 传染病的传播是传染病的传播.
背景情况:
- 公共卫生服务指南根据与乙型肝炎病毒,型肝炎病毒和艾滋病毒传播相关的特征定义了高风险捐赠者 (IRD).
- 与标准风险捐献者 (SRD) 相比,IRD的器官往往被拒绝用于肺移植.
- 2013年的指导方针变化促使重新评估IRD在肺移植中的使用情况.
研究的目的:
- 调查从IRDs与SRDs接受器官的肺移植接受者的指导方针后变化结果.
- 评估利用IRD来扩大捐赠池的安全性和有效性.
主要方法:
- 来自美国器官共享网络登记处的肺移植接受者的回顾性分析 (2014年2月 - 2020年3月).
- 根据捐赠者风险状况将患者分为SRD和IRD队列.
- 使用卡普兰-梅尔曲线,日志等级测试和考克斯比例危险模型进行生存分析.
主要成果:
- 确定了13,205名肺移植接受者 (9,963名SRD,3,242名IRD).
- 在SRD和IRD接受者之间,90天,1年,3年或5年的生存率没有显著差异.
- 与单个肺移植相比,双肺移植与13%的死亡风险降低有关.
结论:
- 来自IRD和SRD的肺移植接受者表现出相当的生存结果.
- 使用IRD是一种安全的策略,可以扩大捐赠者池并提高肺部移植的可用性.
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