美国和欧洲之间接受捐赠心脏的差异:临床影响
Brian Wayda1, Philipp Angleitner2, Jacqueline M Smits3
1Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, CA.
European heart journal
|November 8, 2023
概括
欧洲移植接受的捐赠人心脏比美国 (44%) 多 (70%),即使是老年捐赠者. 采用类似的做法可以增加美国的心脏移植 (HTs) 和减少等候名单问题.
科学领域:
- 移植免疫学 移植免疫学
- 器官捐赠和采购器官的捐赠和采购
- 进行心血管外科手术.
背景情况:
- 心脏移植 (HT) 供体选择实践缺乏共识,并且在美国各中心有很大差异.
- 供体接受和利用的国际差异在很大程度上仍未被探索.
研究的目的:
- 为了比较美国和欧洲移植之间的心脏捐赠者群体和选择实践.
- 评估这些差异对全系统心脏移植结果的影响.
主要方法:
- 欧洲移植 (n=8714) 和美国 (n=60,882) 之间的成人心脏捐赠者特征和利用率 (2010-2020) 的比较分析.
- 多变量后勤回归用于识别捐赠者接受的预测因素.
- 模拟美国采用欧洲移植水平利用的影响.
主要成果:
- 欧洲移植捐赠者年龄较大,患有更多心血管风险因素,但利用率较高 (70%) 与美国 (44%) 相比.
- 捐赠者的年龄,吸烟和糖尿病在两个地区都预测了不接受;肥胖和高血压仅在美国显著.
- 实施欧元移植的利用率可以每年额外产生506-930次美国心脏移植.
结论:
- 欧洲移植显示出比美国更自由的捐赠心脏接受标准.
- 在美国采用类似的做法可以显著增加捐赠心脏的可用性.
- 这可能会降低心脏移植等候名单的发病率和死亡率.
相关概念视频
Kidney Transplant I: Introduction
14
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...
14
Cardiomyopathy II: Dilated Cardiomyopathy
11
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
11
Cardiomyopathy V: Interprofessional Care
14
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
14


