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在捐赠者死亡之前进行心肺复苏是否会影响实体器官移植功能? 一个系统的审查和元分析

Claudio Sandroni¹, Tommaso Scquizzato², Sofia Cacciola³

¹Department of Intensive Care, Emergency Medicine and Anaesthesiology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy; Institute of Anaesthesiology and Intensive Care Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.

|May 23, 2025

概括

在心肺复苏术 (CPR) 后,来自捐赠者的器官移植结果与没有CPR的器官移植结果相似. 然而,来自无控制循环死亡捐赠者的脏和肝脏的移植存活率比脑死亡捐赠者要差.

科学领域:

移植研究移植研究
器官捐献科学器官捐献科学
心肺复苏对器官活力的影响

背景情况:

接受心肺复苏 (CPR) 的捐赠者是移植固体器官的重要来源.
这些器官的缺血-再输液损伤可能会导致接受者的治疗结果较差.
这项研究系统地审查和分析了来自有CPR和没有CPR的捐赠者的固体器官的结果.

研究的目的:

评估从接受心肺复苏的捐赠者移植的固体器官是否表现较差,与没有接受心肺复苏的捐赠者的器官相比.
为了比较不同器官类型和捐赠途径 (大脑死亡与循环死亡) 的移植存活率.

主要方法:

从PubMed,Embase和Cochrane控制试验中心注册册册到2025年1月1日的研究的系统审查和元分析.
主要结局:在最长的随访期内移植的存活率.
二级结局:30天和1年的移植存活率,分别分析每个器官和捐赠途径.

主要成果:

在24项研究中,将脑死亡的捐赠者与没有心肺复苏进行比较,所有器官的结果都没有显著差异.
与脑死亡 (DBD) 后的捐赠相比,在不受控制的循环死亡 (uCD) 后的捐赠显示出较低的长期肝存活率 (OR 0.51) 和较低的短期存率 (OR 0.64).
两项对脏的研究发现,在受控和不受控制的循环死亡捐赠之间,长期存活率没有差异.

结论:

从接受心肺复苏的捐赠者移植的固体器官显示了与没有心肺复苏的捐赠者长期结果相似的长期结果.
来自不受控制的循环死亡捐赠者的脏和肝脏与脑死亡捐赠者的脏和肝脏相比,表现更差.
这些发现表明,要仔细考虑特定器官的捐赠途径,特别是不受控制的循环死亡.

关键词:

心肺复苏心肺复苏的使用方法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医院外心脏骤停医院外心脏骤停

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