来自德国的供体感染的前景
Ana Paula Barreiros1, Klaus Böhler2, Kerstin Mönch3
1Geschäftsführende Ärztin, Deutsche Stiftung Organtransplantation, Region Mitte, Organisationszentrale, Mainz, Germany.
概括
在器官移植中,来自捐赠者的感染很少发生,但会带来很大的风险. 警和监测系统对于提高接收者安全和管理这些严重不良事件至关重要.
科学领域:
- 移植医学 移植医学
- 传染性疾病 传染性疾病
- 公共卫生监督 公共卫生监督
背景情况:
- 器官移植对于终端器官衰竭患者至关重要,可以改善预期寿命和生活质量.
- 尽管在捐赠者和器官评估方面取得了进展,但仍然存在从捐赠者传染疾病的持续风险.
- 源于捐赠者的疾病需要强大的警和监测系统,以有效管理和报告.
研究的目的:
- 分析和报告德国疑似和已证实/可能的捐赠源感染 (DDI).
- 评估DDI在8年 (2016-2023) 的发生率和影响.
- 评估警和监控在接收者安全方面的作用.
主要方法:
- 评估严重不良事件和严重不良反应 (SAE/SAR) 报告,从2016年到2023年,涉嫌DDI.
- 根据美国疾病传播咨询委员会 (DTAC) 的定义进行归咎性分析.
- 仅包括DDI分析的DTAC分类所定义的可能和已证实的情况.
主要成果:
- 包括超过9,771名捐赠者和27,919名接受者;报告了612例SAE/SAR病例,其中377例 (62%) 涉及感染.
- 41个病例被归类为已证实/可能的DDI,影响了58名接受者,导致7人死亡 (12%),一些人失去器官.
- 细菌DDI (48%) 并没有导致接受者死亡,但导致器官损失;真菌DDI (36%) 和病毒DDI (15%) 与较高的死亡率有关.
结论:
- 在实体器官移植中,来自捐赠者的感染 (DDI) 很少发生 (0.21%),但与接受者的大量发病率和死亡率有关.
- 有效的捐赠者评估和可靠的警和监测系统对于提高接受者安全至关重要.
- 这些发现强调了持续监测和报告对于控制器官移植中的感染风险的重要性.
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