药物中毒对供体利用和肝移植结果的影响
Michie Adjei1, Steven A Wisel1,2, Ju Dong Yang2,3
1Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Clinical transplantation
|March 8, 2024
概括
药物过量供体越来越多地被用于肝移植 (LT). 与创伤或中风捐赠者相比,这些捐赠者的移植显示出更好的1年生存率,增强了LT结果.
科学领域:
- 移植医学 移植医学
- 器官捐赠器官捐赠器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器
- 公共卫生 公共卫生
背景情况:
- 药物中毒 (DI) 是捐赠者人口结构的一个重要因素.
- 了解DI对供体利用和移植结果的影响对于优化肝移植 (LT) 计划至关重要.
研究的目的:
- 评估药物中毒 (DI) 作为死亡原因 (COD) 对捐赠肝脏利用的影响.
- 评估DI相关供体对成年肝移植接受者1年移植存活期的影响.
主要方法:
- 对2005-2019年成人首次全肝移植 (LT) 的UNOS STAR数据库的分析.
- 肝脏利用率的后勤回归和1年移植损失风险的比例危险建模.
主要成果:
- 随着时间的推移,DI的捐赠者越来越多地被利用,到2015-2019年,它成为被利用的捐赠者最常见的COD.
- 在已故捐赠者 (DBD) 肝移植患者中,DI-COD 与创伤和CVA/中风捐赠者相比,与更高的1年移植存活率有关.
- 在已故供体 (DCD) 移植中,基于供体的COD,没有观察到1年移植损失的显著差异.
结论:
- 药物中毒 (DI) 与捐赠肝脏利用率的增加有关.
- 与创伤,CVA/中风或其他死亡原因 (COD) 相比,来自DI捐赠者的肝移植显示出更好的1年生存率.
相关概念视频
Factors Affecting Drug Response: Overview
2.0K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
2.0K
Tissue Transplantation
366
Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
366
Factors Influencing Drug Absorption: Disease States and Pharmacology
513
Multiple disease states can significantly influence the oral drug absorption process by affecting blood flow and the functionality of the gastrointestinal (GI) system. Various GI diseases, including conditions that alter GI motility, such as diarrhea, decreased acid secretions (achlorhydria), and infections, have been associated with reduced drug absorption.
Substances such as alcohol and specific drugs, including antineoplastics, can also negatively impact drug absorption. For instance,...
Substances such as alcohol and specific drugs, including antineoplastics, can also negatively impact drug absorption. For instance,...
513
Factors Affecting Drug Distribution: Organ Perfusion Rate
127
Drug distribution within the body is a complex process influenced by several factors, including perfusion rate, the rate at which the bloodstream transports drugs to tissue. This limitation becomes particularly significant when dealing with highly lipophilic drugs. In such cases, the rate at which the drug can move across membranes is crucial, and if the membrane is highly permeable to the drug, distribution becomes rate-limited by perfusion.
Perfusion rate-limited distribution relies on the...
Perfusion rate-limited distribution relies on the...
127
Drug Distribution: Tissue Binding
2.6K
Upon entering the systemic circulation, drugs can distribute into the interstitial and intracellular fluid of various tissue cells. This distribution is facilitated by the binding of drugs to different cellular components within tissues, which may lead to drug accumulation in specific areas. Drugs bound to tissue components serve as reservoirs that release free drugs back into the system, prolonging the drug's overall action. However, this accumulation can also result in local toxicity.
For...
For...
2.6K
Tissue-Drug Binding: Localization of Drugs and its Significance
81
Body tissues, comprising approximately 40% of the body weight, are crucial in drug distribution and localization. These tissues can serve as drug storage sites, competing with plasma binding sites for drug molecules.
Drugs can bind to different tissue components, enhancing their distribution and localization. The factors influencing drug localization in tissues include the drug's lipophilicity, structural characteristics, tissue perfusion rate, and pH differences. These factors determine...
Drugs can bind to different tissue components, enhancing their distribution and localization. The factors influencing drug localization in tissues include the drug's lipophilicity, structural characteristics, tissue perfusion rate, and pH differences. These factors determine...
81


