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来自毒素阳性捐赠者的脏移植结果:一个器官采购和移植网络数据库分析
Lavjay Butani1, Daniel Tancredi2
1Department of Pediatrics, University of California Davis Medical Center, Sacramento, CA, United States.
概括
来自Toxoplasma抗体阳性 (TPD) 捐赠者的器官可以安全地用于移植. 来自TPD的移植接收者显示的移植存活率与毒素体阴性捐赠者的移植存活率相似,支持这些器官的使用.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 移植免疫学 移植免疫学
- 传染性疾病 传染性疾病
背景情况:
- 由于缺乏数据,低于最佳的器官捐赠者经常被排除在外.
- 毒素抗体阳性捐赠者 (TPD) 代表了一组潜在的未充分利用的器官来源.
- 评估使用来自TPD的器官的结果对于扩大捐赠者池至关重要.
研究的目的:
- 在已故的捐赠者移植接受者中,根据捐赠者的Toxoplasma IgG状态来比较移植的存活率.
- 评估使用TPD脏的安全性和有效性.
主要方法:
- 利用器官采购和移植网络 (OPTN) 数据库用于2018-2022年已故捐赠者移植 (Tx) 的数据库.
- 应用了日志线性事件历史回归模型来分析移植失败,并对混因素进行调整.
- 根据捐赠者的Toxoplasma IgG状态进行分层分析.
主要成果:
- 在51,422例移植中,有4,317例 (8.4%) 来自TPD.
- 移植存活率在TPD和毒素原体阴性供体组之间是可比的.
- 移植缺陷的调整后危险率比为1.04 (95% CI:0.94,1.15,p=0.39),表明没有显著差异.
结论:
- 来自TPD的脏移植显示了与托克索普拉斯马阴性捐赠者的移植存活率相似的移植存活率.
- 在移植中可以成功地利用TPD器官,但建议在移植后对毒素菌进行监测.
- 这一发现支持重新考虑TPD器官的接受标准.
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