通过经验建立公平:发展中国家1560次单中心儿科肝移植的见解
João Seda Neto1,2,3, Paulo Chapchap1, Eduardo A Fonseca1,2,3
1Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.
Pediatric transplantation
|November 6, 2025
概括
圣保罗的一个移植团队取得了优秀的儿科肝移植 (PLT) 结果,在34年内进行了1560次手术. 尽管取得了成功,但在低收入和中等收入国家,资金不足和获取差距等挑战仍然存在.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植手术 移植手术
- 儿科胃肠病学 儿科胃肠病学
背景情况:
- 巴西圣保罗的一个移植中心在34年来在儿科肝移植 (PLT) 方面积累了丰富的经验.
- 该中心已经进行了1560个PLT,包括活体供体肝移植 (LDLT),已故供体肝移植 (DDT) 和多米诺手术.
- 500名PLT (2018-2024) 队列中的最近结果显示,1年和5年患者生存率高,分别为96.7%和94.8%.
研究的目的:
- 报告一个低收入和中等收入国家的大量儿科肝移植计划的长期结果和经验.
- 突出该中心对巴西的PLT的重大贡献,特别是对幼儿的贡献.
- 确定和讨论巴西可持续和公平的PLT发展的关键障碍,并提出指导原则.
主要方法:
- 34年来从一个单一中心的儿科肝移植数据的回顾性分析.
- 详细审查患者生存率和手术类型,包括LDLT,DDT和多米诺手术.
- 分析该中心对全国PLT统计的贡献,并确定系统性挑战.
主要成果:
- 在34年的时间里,进行了1560次儿科肝移植,其中1352次LDLT,179次DDT和29次多米诺手术.
- 在最近的队列 (2018-2024) 中,1年和5年患者生存率分别为96.7%和94.8%.
- 该中心在2015-2024年期间在巴西进行了所有PLT的35.1%,以及5岁以下儿童的45.5%,其中98.1%使用LDLT.
结论:
- 儿科肝移植的优秀长期结果即使在资源有限的环境中也是可以实现的.
- 重要的结构性挑战,包括资金不足和获取差异,阻碍了巴西公平的PLT发展.
- 机构承诺,战略投资和国家协调对于推进儿科肝移植和确保公平获取至关重要.
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