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肝脏机器输液技术:扩大捐赠者库,以改善获得肝脏移植的机会
Stalin Canizares1, Adriana Montalvan1, Ritah Chumdermpadetsuk1
1Division of Transplant Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
概括
机器输液 (MP) 增加了肝移植的访问,使中心能够利用更多的扩展标准的捐赠者,包括在循环死亡和老年捐赠者后捐赠的捐赠者. 这项技术扩大了捐赠肝脏的利用范围,超出了传统的限制.
科学领域:
- 移植医学 移植医学
- 器官采购 器官采购
- 手术技术 手术技术
背景情况:
- 器官供应和需求之间的持续不平衡阻碍了更广泛的器官移植益处.
- 由于传统的保存限制,扩展标准的捐赠者往往未得到充分利用.
研究的目的:
- 评估机器输液 (MP) 实施对移植中心行为的影响.
- 评估MP采用如何影响扩展标准供体肝脏的利用.
主要方法:
- 统一器官共享网络/器官采购和移植网络数据的分析.
- 15个高利用率的MP中心与合适的控制中心进行了匹配比较.
- 使用线性回归来分析差异差异,以评估捐赠者利用率的变化.
主要成果:
- 采用MP与增加冷缺血时间和捐赠者热缺血时间>30分钟相关.
- 在循环死亡捐赠者之后,MP中心接受了更多的捐赠,包括那些50岁以上的捐赠者.
- MP 允许接受具有显著的宏肌肉肥胖症 (>30%) 和长时间的温暖缺血时间的捐赠者.
结论:
- 机器输液允许移植中心扩大使用超越传统标准的扩展标准捐赠者的范围.
- 通过扩大捐赠肝脏的利用,MP的实施增加了患者获得肝脏移植的机会.
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