对已故捐赠者脏的提前开放报价的评估 脏处于非利用风险之中
Vikram Kilambi1,2, Masoud Barah3, Richard N Formica4
1Department of Engineering and Applied Sciences, RAND Corporation, Arlington, Virginia.
Clinical journal of the American Society of Nephrology : CJASN
|November 9, 2023
概括
向更多接受者开放具有高脏捐赠者风险指数 (KDRI) 的脏供应可以减少器官浪费. 调整供应时间显著降低了这些脏的非利用率.
科学领域:
- 移植科学 移植科学
- 器官分配政策 器官分配政策
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 已故捐赠者的脏未使用是美国的一个重大问题.
- 具有高脏捐赠者风险指数 (KDRI) 的脏更有可能无法利用.
- 目前的脏分配政策正在重新评估,以改善器官使用.
研究的目的:
- 为了评估开放高KDRI脏提供给更广泛的等候名单的影响.
- 为了确定不同的报价时间如何影响脏使用率.
- 评估本地与国家对高KDRI脏的供应扩展的有效性.
主要方法:
- 用2018年1月至2019年6月的数据模拟了的分配.
- 该模拟修改了分配政策,在设定的冷时间后为当地候选人提供KDRI>1.75个器官.
- 还模拟和检查了国家供应扩展.
主要成果:
- 10小时后KDRI>1.75的局部开放报价减少了非利用率从55%降至38%.
- 将提供时间减少到5小时,在本地进一步降低了非利用率至30%.
- 在10小时和5小时的全国性报价扩张中,未使用率分别为11%和6%.
结论:
- 开放高KDRI脏的报价可以显著减少非利用.
- 调整这些公开报价的时间对于最大限度地利用脏至关重要.
- 涉及扩大和定时报价的政策修改表明,改善已故捐赠的分配有望实现.
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