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感冒缺血时间和捐赠者年龄对循环死亡后捐赠的影响 移植结果:UNOS Mate-Kidney分析
Gabriel Cojuc-Konigsberg1, Belen Rivera2, Stalin Cañizares2
1Division of Nephrology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Clinical transplantation
|December 5, 2024
概括
在已故捐赠者 (DCD) 移植患者中,超过24小时的长期冷缺血时间 (CIT) 并没有影响长期的移植存活率. 然而,较长的CIT增加了延迟移植功能 (DGF) 的风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 移植免疫学 移植免疫学
- 器官的保存 器官的保存
背景情况:
- 关于长期冷血缺血时间 (CIT) 和捐赠者年龄对循环死亡 (DCD) 后捐赠者移植接受者 (KTR) 的影响存在不确定性.
- 评估这些因素对于优化DCD利用率和改善移植结果至关重要.
研究的目的:
- 根据CIT和供体年龄,比较DCD供体KTR中的全移植结果.
- 调查CIT,供体年龄和关键移植结果之间的关联,包括移植失败和患者存活率.
主要方法:
- 从UNOS数据库 (2010-2024) 中对4092对DCD捐赠进行了对分析.
- 结局在脏与CIT>24小时与≤24小时之间进行了比较,并在不同年龄组和CIT三角洲之间进行了比较.
- 多变量Cox比例危险模型和条件后勤回归被用于评估患者死亡,全移植失败,死亡审查移植失败 (DCGF) 和延迟移植功能 (DGF).
主要成果:
- 在DCD脏与CIT>24小时之间,与CIT ≤24小时之间,没有观察到患者死亡,全因移植衰竭或DCGF的显著差异.
- 当按捐赠者年龄组分层并比较伴侣脏之间的CIT delta时,观察到类似的结果.
- 长时间的CIT (>24小时) 和增加的CIT三角形与更高的DGF概率有关.
结论:
- 在DCD移植中,超过24小时的冷性缺血时间与不良的长期异位移植结果无关,无论捐赠者的年龄如何.
- 然而,长时间的CIT与延迟移植功能的发病率增加有关.
- 应该考虑接受来自DCD捐赠者的两个脏,即使预计CIT超过24小时.
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