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心脏移植的结果是否因捐赠者和接受者的种族而异?
David Blitzer1, J'Undra N Pegues2, Seth T Lirette3
1Columbia University, Department of Surgery, Division of Cardiovascular Surgery, New York, New York, USA.
Clinical transplantation
|September 19, 2023
概括
与白人接受者相比,非洲裔美国人和西班牙裔接受者在心脏移植后的生存率下降. 捐赠者种族没有影响存活率,但在心脏移植 (OHT) 后的结果和特征仍然存在差异.
科学领域:
- 心脏病学 心脏病学
- 移植医学 移植医学
- 健康差距 研究 研究 研究 研究
背景情况:
- 有限的数据存在于捐赠者和接受者的种族如何影响心脏移植 (OHT) 后的结果.
- 了解这些种族动态对于解决心脏移植护理中的潜在差异至关重要.
研究的目的:
- 评估捐赠者和接受者种族之间的关系及其对OHT结果的影响.
- 为了确定种族一致或不一致是否会影响患者的生存率和移植后排斥率.
主要方法:
- 联合国器官共享网络 (UNOS) 数据库的回顾性审查 (2000年1月 - 2018年3月).
- 分析包括41,841例OHT病例,基于捐赠者和接受者种族 (白人,黑人,西班牙裔) 的结果进行了比较.
- 统计模型 (逻辑和Cox) 用于评估30天和1年的生存率和排斥率.
主要成果:
- 与白人接受者相比,西班牙裔接受者30天 (OR 1.27) 和1年 (OR 1.17) 的生存率下降.
- 涉及非裔美国接受者的捐赠者-接受者组合 (无论捐赠者的种族) 与白人-白人的组合相比,总体存活率下降.
- 黑人接受者更有可能接受紧急状态的心脏,而西班牙裔接受者更有可能接受非紧急移植.
结论:
- 与白人接受者相比,非洲裔美国人和西班牙裔接受者经历心脏移植后的生存率降低.
- 捐赠者种族似乎不会对生存产生负面影响,但在OHT中仍然存在显著的种族差异.
- 建议扩大所有种族和种族的捐赠者池,以潜在地改善结果并减少差异.
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