低收入和中等收入国家的末期儿科心力衰竭:手术管理的挑战
1Institute of Heart and Lung Transplant, MGM Healthcare, Nelson manickam road , Chennai, India.
概括
在低收入和中等收入国家 (LMIC) 的儿科心脏移植面临着供体短缺和成本挑战. 尽管如此,成功的项目是可以实现的,其结果与国际标准相美.
科学领域:
- 心血管外科心血管外科
- 儿童心脏病学 儿童心脏病学
- 移植医学 移植医学 移植医学
背景情况:
- 儿童末期心力衰竭在低收入和中等收入国家 (LMIC) 提出了独特的挑战.
- 资源有限,捐赠者可用性和基础设施影响儿科心脏移植的结果.
- 印度的经验为应对这些挑战提供了一个模式.
研究的目的:
- 在LMIC中确定末期心力衰竭的手术治疗中的障碍.
- 为在资源有限的环境中建立和维持儿科心脏移植计划提出可行的解决方案.
主要方法:
- 在印度一家手术科室进行了超过10年的141次儿科心脏移植手术的回顾性分析.
- 纳入标准:年龄在18岁以下的患者,包括机械循环支的患者.
- 数据收集的重点是供体特征,受体状况,术后因素和长期结果.
主要成果:
- 90天生存率为85.11%,10年生存率超过70%.
- 医院死亡的危险因素包括低INTERMACS得分,高肌素和移植前右心房压升高.
- 捐赠者年龄>25岁与较差的长期结果有关;捐赠者-接受者体重比率与国际规范不同.
结论:
- 尽管面临重大挑战,但在LMIC中可以建立成功的儿科心脏移植计划.
- 创新解决方案,包括优化器官运输物流,对于计划的可持续性至关重要.
- 在这个LMIC环境中取得的结果与全球报告的结果相似.
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