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Isolated Lung Perfusion System in the Rabbit Model
Published on: July 15, 2021
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集中静态活体肺输液在美国
Qiudong Chen1, Jad Malas1, Michael E Bowdish1
1Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
The Annals of thoracic surgery
|August 28, 2024
概括
集中式ex vivo肺 perfusion (EVLP) 设施提供与个人中心相似的肺移植结果. 这种模式可以改善更多需要肺移植的患者获得EVLP的机会.
科学领域:
- 心血管和呼吸系统科学 心血管和呼吸系统科学
- 移植科学 移植科学
- 医疗工程 医学工程
背景情况:
- 活体肺 perfusion (EVLP) 可以提高供体肺的利用率,但需要大量的基础设施和专业知识.
- 集中式的EVLP设施可以简化资源需求和专业知识.
- 评估集中式EVLP的有效性和安全性对于更广泛的采用至关重要.
研究的目的:
- 通过静态EVLP在集中设施与个体移植中心注射的供体肺部进行肺移植的结果进行比较.
- 评估集中式EVLP对捐赠肺部利用率和移植成功率的影响.
- 为了确定一个集中式的EVLP模型是否会影响肺移植后的患者存活率.
主要方法:
- 利用联合器官共享网络数据库识别了345名成年肺移植接受者 (2018年3月至2022年12月).
- 在集中EVLP设施 (n=165) 输入肺的接受者与在单个中心 (n=180) 输入肺的接受者进行了比较.
- 员工倾向得分匹配,以创建平衡的小组,以便进行可靠的比较分析.
主要成果:
- 集中式EVLP使用量显著增加 (35.3%至55.8%,P=.04) 并更常见于年度中心EVLP数量较低的EVLP.
- 在集中设施注射的肺具有较长的缺血时间 (11.3 vs 9.6 小时,P<.001),并且在循环死亡捐赠者 (25.4% vs 39.5%,P=.003) 之后捐赠的可能性较小.
- 在匹配对的两组中,两年生存率在两组之间相当 (77.9% vs 77.7%,P=.90),由多变量考克斯回归 (aHR=1.02,P=.95) 证实.
结论:
- 肺移植的结果是相似的,无论静态EVLP是在集中设施或个体移植中心进行的.
- 集中式的EVLP模型显示了增加对这种肺部保护技术的访问的潜力.
- 集中式EVLP提供了一个可行的替代方案,可能扩大边缘捐赠肺的使用.
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