在安乐死后的捐赠后,移植结果
Julia S Slagter1, Hendrikus J A N Kimenai1, Jacqueline van de Wetering2
1Division of Hepatobiliary and Transplant Surgery, Department of Surgery, Erasmus MC Transplant Institute, Rotterdam, the Netherlands.
JAMA surgery
|September 25, 2024
概括
与DCD-III相比,安乐死后器官捐献 (DCD-V) 脏移植显示了延迟移植功能的减少. DCD-V移植的长期结果与DCD-III和脑死亡后捐赠 (DBD) 移植相似.
科学领域:
- 科和移植手术 移植手术
- 器官捐赠和移植器官的使用
- 公共卫生政策 公共卫生政策
背景情况:
- 自2012年以来,安乐死后器官捐赠 (循环死亡型V [DCD-V]) 在荷兰有所增加.
- DCD-V移植的结果需要彻底调查,以评估其安全性和在扩大捐赠池中的价值.
研究的目的:
- 为了评估使用DCD-V移植的移植的结果.
- 为了比较DCD-V移植结果与循环死亡后捐赠的结果 (DCD-III) 和脑死亡后捐赠的结果 (DBD).
主要方法:
- 使用荷兰移植基金会数据进行的回顾性队列研究 (2012年1月 - 2023年7月).
- 用DCD-V移植与DCD-III和DBD移植进行的移植的比较.
- 主要结局:5年死亡审查的移植存活期;次要结局:延迟的移植功能 (DGF),永久的非功能 (PNF),血清肌氨酸和患者存活期.
主要成果:
- 与DCD-III (49%) 相比,DCD-V移植患者 (n=145) 的DGF发病率显著降低 (26%) 和DBD发病率相似 (22%).
- 在DCD-V (6%) 和DCD-III (6%) 之间,永久性功能障碍 (PNF) 的发生率相似,但高于DBD (4%).
- 五年死亡审查的移植存活率 (DCD-V:82%,DCD-III:86%,DBD:84%) 和患者存活率 (DCD-V:69%,DCD-III:76%,DBD:73%) 在所有组中都是可比的.
结论:
- 与DCD-III相比,DCD-V移植显示了较低的DGF发病率.
- DCD-V移植的长期移植和患者存活率与DCD-III和DBD相当.
- 研究结果支持DCD-V作为一种安全和有价值的方法来增加脏捐赠者池.
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