来自非理想捐赠者的器官利用率,用于美国固体器官移植
Steven A Wisel1,2, Daniel Borja-Cacho3, Dominick Megna4
1Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Journal of clinical medicine
|June 19, 2024
概括
非理想捐赠者 (NID) 越来越多地被用于固体器官移植,其用于肝脏,心脏和肺部移植的使用量显著增加. 一个复合的捐赠者利用率 (DUS) 可以进一步优化识别多器官捐赠者.
科学领域:
- 器官移植研究器官移植研究
- 捐赠者的特征和利用方法
- 公共卫生和捐赠政策中的公共卫生和政策.
背景情况:
- 非理想供体 (NID) 提供可行的全移植,可能扩大固体器官移植的供体池.
- 了解NID特征和利用趋势对于优化器官分配至关重要.
- 以前的研究还没有在所有固体器官中一致定义或评估NID.
研究的目的:
- 评估美国所有固体器官在15年内非理想供体 (NID) 的利用趋势.
- 分析捐赠者的特征,包括年龄和并发症,对器官利用的影响.
- 评估复合捐赠者利用率 (DUS) 在识别潜在多器官捐赠者的有效性.
主要方法:
- 对OPTN STAR数据库对2005-2019年捐赠者的分析,分为三个时期.
- 根据年龄和并发性疾病的综合捐赠者利用率 (DUS) 将捐赠者分为理想或非理想的分类.
- 多变量后勤回归用于确定影响整体和器官特定供体利用的因素.
主要成果:
- 与理想捐赠者相比,非理想捐赠者 (24.7%) 年龄较大,更有可能是女性,黑人和肥胖.
- 总体而言,从NID中利用已故捐赠者的脑死亡 (DBD) 在三个时期内显著增加.
- 在后期的肝脏,心脏和肺部移植中,NID的使用量大幅增加,而脏移植的使用量略有下降.
结论:
- 在多个器官中,用于固体器官移植的非理想捐赠者 (NID) 的使用正在增加.
- 一个标准化的定义和复合的捐赠者利用率 (DUS) 的使用可以提高多器官捐献的NID的识别.
- 进一步研究优化NID利用是有必要的,以解决器官短缺问题.
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