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尸体和活体捐赠者叶叶肺移植的再接收和成本:使用国家数据库进行分析

Nobuyuki Yoshiyasu¹, Taisuke Jo^2,3, Masaaki Sato^1,4

¹Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan.

|March 27, 2025

概括

与死体肺移植 (CLT) 相比,活体捐赠者叶叶肺移植 (LDLLT) 显著降低了再入院和医疗费用. 这项研究强调了LDLLT.

科学领域:

胸部外科手术胸部外科手术
移植医学移植医学
卫生经济学卫生经济学

背景情况:

活体捐赠者叶叶肺移植 (LDLLT) 已经确立,但再接收率和成本尚不清楚.
尸体肺移植 (CLT) 是标准的,已知但潜在的高后释放资源利用率.

研究的目的:

为了比较LDLLT和CLT之间的医疗费用和退院后90天和1年的再入院频率.
在两种移植类型中确定再入院和住院死亡的原因.

主要方法:

使用日本诊断程序组合数据库进行的回顾性队列研究 (2010年7月 - 2020年3月).
包括514名肺移植接受者:115名LDLLT和399名CLT.
多变量Poisson/多次回归分析在多次归算后进行,以比较结果.

主要成果:

LDLLT组的原始再入院率 (90天:22%对37%;1年:48%对62%) 和中位成本 (90天:0美元对0美元;1年:1178美元对4714美元) 比CLT更低.
多变量分析证实LDLLT与较低的再接收风险 (IRR0.59) 和90天成本 (差异-11,629美元) 相关.
在这两组人群中,肺炎是再入院最常见的原因.

结论:

与尸体肺移植相比,活体捐赠者叶叶肺移植与明显较低的再接收率和医疗保健支出有关.
研究结果支持LDLLT作为一个具有成本效益的替代方案,因此需要在更大的队列中进行进一步的研究.
肺炎仍然是重新接收的关键因素,无论捐赠者类型如何.

关键词:

费用费用费用费用费用费用肺部疾病肺部疾病肺部移植肺部移植国家数据库国家数据库.重新住院治疗的情况.

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