优化废弃风险的已故捐赠脏的使用:临床实践指南
Joanna C Dionne1,2,3, Patricia Campbell4, Héloïse Cardinal5,6
1Department of Medicine, McMaster University, Hamilton, ON, Canada.
概括
该指南建议使用已故捐赠者的脏,因为有丢弃移植的风险. 建议包括使用扩展标准捐赠脏 (ECD) 和急性损伤脏,以改善器官利用率.
科学领域:
- 科和移植手术 移植手术
- 器官捐赠和移植器官的使用
- 临床实践指南 临床实践指南
背景情况:
- 在可用的已故捐赠脏和患者需要移植之间存在很大的差距.
- 不充分利用已故捐赠器官,特别是那些有丢弃风险的器官,加剧了这种短缺.
研究的目的:
- 提供关于利用已故捐赠脏的临床建议,这些脏有很高的丢弃风险.
- 改善器官利用率,并为移植的共同决策提供信息.
主要方法:
- 基于证据审查的临床实践指南的制定.
- 关于使用特定的捐赠类型的六项有条件建议的制定.
主要成果:
- 发布了六项有条件的建议,所有这些建议的证据确定性非常低.
- 建议支持使用扩展标准捐赠者 (ECD) 脏,来自老年捐赠者的脏,以及来自急性损伤 (AKI) 捐赠者的脏.
- 在循环确定死亡后,还建议利用捐赠者的脏.
结论:
- 该指南提供了基于证据的建议,用于使用有丢弃风险的已故捐赠脏.
- 实施这些建议可能会增加移植率并改善患者的治疗结果.
- 预计临床医生和患者之间将加强共享决策.
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