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移植的分配规则和年龄相关的等待时间

Benedikt Kolbrink¹, Nassim Kakavand, Jakob C Voran

¹Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany; Department of Internal Medicine III, Cardiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; German Center for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Lübeck, Germany; Peter L. Reichertz Institute for Medical Informatics (PLTI), TU Braunschweig and Hannover Medical School, Hannover, Germany; German Organ Procurement Organization (DSO), Frankfurt am Main, Germany; Eurotransplant International Foundation, Leiden,Netherlands; Institute of Ethics and History of Medicine, University Medicine Göttingen, Göttingen, Germany; Division of Clinical Transplantation Medicine, Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig Holstein Campus Kiel, Kiel, Germany.

Deutsches Arzteblatt international

|August 8, 2024

概括

严格的年龄限制在德国脏移植正在增加18-64岁患者的等待时间. 重新评估这些分配规则对于改善患者的治疗结果和移植的准入至关重要.

科学领域:

腎臟病學 (nephrology) 是一種醫學.
移植医学移植医学
公共卫生政策公共卫生政策

背景情况:

目前的德国脏分配系统有严格的年龄限制.
这些年龄限制的潜在负面影响需要调查.
德国国家移植登记处提供了用于分析的数据.

研究的目的:

分析严格的年龄限制对德国脏移植等待时间的影响.
评估从2006年至2020年的脏分配数据.

主要方法:

利用来自德国国家移植登记处的匿名数据.
分析了从2006年到2020年通过Eurotransplant分配的脏移植.
在不同年龄组和分配计划中比较等待时间.

主要成果:

分析了19,664例脏移植;中位等待时间为5.8年.
18-64岁的患者平均等了7.0年,比年轻或年长的群体要长得多.
随着时间的推移,欧洲移植分配系统 (ETKAS) 和欧洲移植高级计划 (ESP) 之间的等待时间差异越来越大.

结论:

严格的年龄限制在德国脏分配规则中延长了18-64岁患者的等待时间.
目前的分配规则需要从根本上重新评估,以改善移植机会.
数据表明,需要改变政策,以优化脏捐献器官的分配.

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