异序分配的当代流行和实践模式
Luckmini N Liyanage1, Daniyar Akizhanov1, Suhani S Patel1
1Department of Surgery, NYU Langone, New York, New York, USA.
概括
异序 (OOS) 分配显著增加,近20%的安置发生在标准序列之外. 这种做法,通常涉及脏下降了多次,可能会加剧现有的健康差异.
科学领域:
- 移植科学 移植科学
- 器官分配政策 器官分配政策
- 健康 公平 卫生 公平
背景情况:
- 器官采购和移植网络 (OPTN) 观察到,自2021年以来,异序 (OOS) 的分配大幅增加.
- 这一增长引发了人们的担忧,并暂停了对移植的持续分发政策的制定.
研究的目的:
- 使用OPTN数据分析OOS脏分配的当代实践模式 (2022-2023年).
- 调查与OOS移植相关的供体和受体特征.
- 评估OOS分配对移植的可变性和潜在影响.
主要方法:
- 利用2022-2023年的OPTN数据来检查脏安置.
- 采用多变量后勤回归在序列与OOS捐赠者之间.
- 使用条件后勤回归用于跳过与OOS接受接收者.
主要成果:
- 近20%的脏安置是OOS,在各个器官采购组织 (0%至43%) 中存在显著差异.
- 在OOS分配之前,许多OOS脏被拒绝了多次 (33%被拒绝了≥100次).
- OOS脏更有可能来自老年人,黑人,女性和具有特定并发症的捐赠者;接受者通常是老年人和亚洲人.
结论:
- 目前对OOS脏分配的自由使用是高度可变的,可能会加剧现有的移植差异.
- 需要进一步的研究来确定OOS分配对整体器官利用的确切影响.
- 这些发现凸显了对OOS脏分配实践的政策审查的必要性.
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