捐赠者距离对现代移植后死亡率的影响
David Rekhtman1, Sharon Lee1, Amit Iyengar2
1Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa.
JTCVS open
|July 9, 2025
概括
心脏移植的长时间旅行不会影响存活率. 关注缺血时间,而不是距离,为器官采购政策改善心脏移植结果.
科学领域:
- 心脏病学 心脏病学
- 移植医学 移植医学
- 公共卫生政策 公共卫生政策
背景情况:
- 美国心脏移植分配系统允许器官超过250英里.
- 长途旅行和相关的缺血时间对心脏移植结果的影响尚不清楚.
研究的目的:
- 为了检查捐赠者-接受者距离和移植后死亡率之间的关系.
- 评估长时间旅行对缺血时间和心脏移植患者存活率的影响.
主要方法:
- 在2018年10月至2023年9月期间,使用联合器官共享网络数据库对接受隔离心脏移植的成年患者进行分析.
- 基于捐赠者距离 (≤250或>250英里) 的患者分层,并使用回归和卡普兰-梅尔方法分析1年生存率,缺血时间和死亡率.
主要成果:
- 在5315名心脏移植接受者中,有55%的人从250英里外的捐赠者那里接受了器官.
- 旅行距离每增加100英里,缺血时间增加18分钟.
- 增加的缺血时间预测死亡率,但增加的捐赠者距离没有影响1年的生存率.
结论:
- 捐赠者-接受者旅行距离对缺血时间的影响很小,对移植后1年生存时间没有显著影响.
- 缺血时间,而不是任意的距离切断,应该指导心脏移植器官采购政策.
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