OPTN/SRTR 2022 年度数据报告:肠道
Simon P Horslen1, Yoon Son Ahn2, Nicholas L Wood2
1Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN; Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA.
概括
肠道移植正在下降,特别是在儿童中,成年候选人候选人越来越多. 成人移植率有所下降,特别是在结合肠肝病例中,而儿科的生存率仍然更好.
科学领域:
- 移植医学 移植医学
- 胃肠病学 胃肠病学
- 儿科手术 儿科手术
背景情况:
- 肠道移植是不可逆转的肠道衰竭的救生程序,但它仍然是最少进行的固体器官移植.
- 在过去的15年中,人们观察到肠道移植清单和手术减少的令人担忧的趋势,不成比例地影响了儿科人口.
研究的目的:
- 分析肠道移植的最新趋势,包括等待列表动态,移植率和结果.
- 确定导致成年人肠移植减少的因素,并比较儿科和成年接受者之间的结果.
主要方法:
- 从2022年起,对国家肠子移植数据的回顾性分析.
- 检查等待名单的人口统计数据,移植率,移植前死亡率和移植/患者存活率.
- 孤立肠道移植与结合肠肝移植的结果的比较.
主要成果:
- 肠移植人数在2022年下降至82人,成人候选人占候选人名单的61%.
- 成人移植率下降至每100个患者年中的55.6,主要是由于肠肝联合移植的数量减少.
- 儿科移植率保持稳定,为每100个患者年中的22.8;儿科接受者表现出更好的移植和患者存活率.
- 单独的肠道移植改善了移植失败率,但组合手术没有.
- 移植后淋巴增殖障碍的发病率在仅肠移植的接受者中更高.
结论:
- 肠道移植的下降趋势,特别是对于儿科患者,需要紧急关注.
- 结合肠肝移植候选人面临更高的移植前死亡率,凸显了这些程序的复杂性.
- 虽然孤立肠道移植的结果显示有所改善,但儿科接受者的整体移植和患者存活率更好.
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