儿童在2岁之前是否应该接受脏移植?
Sarah J Kizilbash1, Michael D Evans2, David M Vock3
1Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA.
Pediatric transplantation
|November 8, 2023
概括
在2岁之前进行移植可以改善患有衰竭的儿童的存活率. 早期移植 (在2岁之前) 提供了较好的患者存活率和较少的透析,而不是等到2岁.
科学领域:
- 儿科脏病学 儿科脏病学
- 移植手术 移植手术
- 临床结果研究研究
背景情况:
- 对于患有功能衰竭的婴儿和幼儿进行移植的最佳时间仍然不确定.
- 这项研究比较了患者在2岁之前移植脏的存活率与在等待名单上保持2岁或以上的患者存活率.
研究的目的:
- 评估与早期移植相关的患者存活率 (在2岁之前).
- 为了比较早期移植的结果与儿童功能衰竭患者的持续等待列表.
主要方法:
- 利用移植受体科学注册表 (SRTR) 来获取2000-2020年的数据.
- 被识别的儿童在2岁之前被添加到已故捐赠者等候名单中.
- 采用顺序的考克斯回归来分析患者的存活率和定义的无透析时间进行比较.
主要成果:
- 与等待名单上的对照组相比,在2岁之前移植的儿童的长期患者存活率 (>12个月) 较高.
- 2岁以下的已故捐赠者和活着的捐赠者接受者都经历了显著改善的生存率.
- 早期移植受体的5年无透析生存时间明显高于早期移植受体 (0.59年为已故捐赠者,1.84年为活体捐赠者).
结论:
- 2岁以下儿童的移植与更好的患者存活率有关.
- 早期移植显著降低了儿科患者功能衰竭的整体透析暴露.
- 与长期等待名单相比,在2岁之前移植婴儿和幼儿的结果有所改善.
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