在循环死亡后捐献的全球经验,用于儿科肺移植
Hosam F Ahmed1, Kevin Kulshrestha1, Spencer Hogue1
1Cincinnati Children's Hospital Medical Center, Cardiothoracic Surgery, Cincinnati, Ohio, United States.
Annals of the American Thoracic Society
|October 15, 2024
概括
使用循环死亡 (DCD) 后捐赠器官的儿科肺移植显示出与脑死亡 (DBD) 后捐赠器官相似的生存率. 这种方法支持为需要肺移植的儿童增加器官的可用性.
科学领域:
- 儿科移植 儿科移植
- 胸部外科手术 胸部外科手术
- 器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器
背景情况:
- 循环死亡后捐献 (DCD) 越来越多地用于肺移植,但儿童接受者的数据有限.
- 儿童肺移植面临着严重的捐赠器官短缺问题.
研究的目的:
- 为了比较使用DCD的儿科肺移植与脑死亡 (DBD) 器官捐赠后的结果.
- 评估儿童DCD肺捐献的可行性,以解决器官短缺问题.
主要方法:
- 分析国际心脏和肺移植协会 (ISHLT) 胸部器官移植注册数据 (2004-2018) 的数据.
- 34名儿科DCD肺移植接受者与1419名儿科DBD肺移植接受者的比较.
- 使用倾向分数匹配来创建可比的队列来进行结果分析.
主要成果:
- 卡普兰-梅尔生存率和倾向性得分匹配分析显示,DCD和DBD儿科肺移植接受者之间的移植后生存率相似 (P=0.098).
- DCD肺移植接受者经历了更长的移植后住院时间 (匹配的队列:26天与19天,P=0.016).
- 在DCD接受者中观察到急性细胞排斥 (ACR) 时间缩短的趋势 (匹配的队列:248天与1650天,P=0.059).
结论:
- 这项研究支持使用DCD进行儿科肺移植,这可能会增加儿童的捐赠器官可用性.
- 需要进一步的研究来探索观察到的儿童DCD肺移植接受者急性细胞排斥的较短时间.
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