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在现实生活中建立一个HOPE计划:一个巴西案例系列
Amanda P C S Boteon1, Marisa R D Lima1, Bianca Della Guardia1
1Transplant Center, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Transplantation direct
|November 13, 2023
概括
低温氧化输液 (HOPE) 在巴西成功用于高风险的肝移植,显示出优异的移植和患者存活率. 实施面临成本和监管挑战,但该途径为资源有限的设置提供了一个模型.
科学领域:
- 移植医学 移植医学
- 器官的保存 器官的保存
- 手术创新 在外科创新.
背景情况:
- 低温氧化输液 (HOPE) 可以改善移植后的结果.
- 建立机器输液程序面临着独特的挑战.
- 本研究详细介绍了 HOPE 在巴西的实际实施情况.
研究的目的:
- 描述在巴西建立低温氧化 perfusion (HOPE) 计划的情况.
- 评估 HOPE 的可行性和结果,以扩展标准的捐赠器官在具有挑战性的环境中.
- 确定实施先进器官保存技术的障碍和促进因素.
主要方法:
- 使用扩展标准捐赠者 (ECD) 器官,为高风险移植候选人保留HOPE.
- 根据欧洲移植标准定义的ECD,根据次优外科条件定义的高风险候选人.
- 在2022年2月至8月期间移植了6个HOPE保存的移植.
主要成果:
- 平均捐赠者风险指数为1.7;3个器官预计患有冷血缺血>12h.
- 接受者的MELD得分平均为28.67,包括复杂的病例,如再移植.
- 在15个月的随访中,实现了100%的移植和患者存活率,没有早期的全移植功能障碍或缺血性胆血管病变.
结论:
- 在具有挑战性的捐赠者-接受者场景中引入HOPE的途径得到了积极的结果.
- 这些发现支持实施机器 perfusion 计划,特别是在资源有限或物流复杂的环境中.
- 成本和监管障碍是实施计划的主要障碍.
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