我们如何增加已故捐赠脏的利用率并减少丢弃?
Venkatesh K Ariyamuthu1, Abd A Qannus, Bekir Tanriover
1Division of Nephrology, University of Arizona, COM, Tucson, Arizona, USA.
Current opinion in organ transplantation
|February 13, 2025
概括
扩大已故捐赠脏库涉及使用来自急性损伤 (AKI),C型肝炎病毒 (HCV) 和乙型肝炎病毒 (HBV) 的捐赠者的边缘器官. 先进的保存技术改善了结果,并增加了移植的机会.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 移植 移植 移植 移植
- 器官的保存 器官的保存
背景情况:
- 美国面临着死去的捐赠脏的严重短缺,导致活跃器官的丢弃率很高.
- 低最佳和高风险脏,包括来自急性损伤 (AKI),C型肝炎病毒 (HCV) 和乙型肝炎病毒 (HBV) 的捐赠者的脏,往往未得到充分利用.
研究的目的:
- 审查扩大已故捐赠脏库的策略.
- 为了降低美国可行的脏的丢弃率.
- 探索使用边缘和高风险的捐赠脏.
主要方法:
- 审查器官保存技术的进步,包括低温和正常热机器输液.
- 对心脏死亡 (DCD) 后捐献的正常热区域输液 (NRP) 的分析.
- 对 AKI,HCV 和 HBV 的捐赠者的结局结果的检查.
主要成果:
- 低温和正常热机器输液改善了边缘和扩展标准脏的结果.
- 在DCD捐赠者中,NRP提高了器官利用率和移植活力.
- 来自AKI和HCV阳性捐赠者的脏的长期结果与采用适当方案的标准移植结果相比较.
- 阳性HBV的捐赠脏有可能通过抗病毒预防来扩大移植的机会.
结论:
- 优化已故捐赠的利用需要一个多方面的方法.
- 对于高风险器官来说,保存技术的进步和基于证据的决策至关重要.
- 需要政策创新来解决器官短缺问题,并提高移植机会.
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