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类似的目标,不同的路径:探索心脏移植中C型肝炎治疗方案的方法
Roopa A Rao1, Sonu Abraham2, Amanda R Vest3
1Division of Cardiovascular Medicine, Indiana University School of Medicine, Indianapolis, IN.
Journal of cardiac failure
|February 3, 2025
概括
来自C型肝炎阳性捐赠者的心脏移植受体的管理有很大差异. 大多数中心使用直接的抗病毒疗法,但时间和协议不同,强调需要标准化的指导方针和研究.
科学领域:
- 移植医学 移植医学
- 肝病学 肝病学是一种肝病学.
- 传染性疾病 传染性疾病
背景情况:
- 越来越多地使用C型肝炎病毒 (HCV) 阳性捐赠者进行心脏移植.
- 缺乏对受益人最佳管理策略的共识.
研究的目的:
- 为了调查当前的实践,从HCV NAT阳性捐赠者的心脏移植接受者管理.
- 为了确定直接抗病毒疗法 (DAA) 协议和监测的变化.
主要方法:
- 在线调查美国和加拿大心脏移植中心 (2023年1月至2024年2月).
- 收集关于DAA使用,时间,持续时间,病毒载量测试,不良影响和免疫抑制的数据.
- 分析的重点是美国成年人计划与HCV移植协议.
主要成果:
- 在122个 (28.7%) 的中心中,有35个做出了反应;689个使用HCV NAT阳性捐赠者的移植被确定.
- 在美国的中心中,16.7%使用预防性,30%使用预防性和53.3%使用反应性DAA治疗.
- 泛基因型DAA疗法使用的中位数为12周;观察到协议中的显著异质性.
结论:
- 在管理HCV NAT阳性供体心脏方面存在显著的实践模式变化.
- 需要患者登记册和随机对照试验来指导未来的临床实践.
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