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在脏交换计划中浏览一个难题:对捐赠者旅行与器官运输的审查
Mattheüs F Klaassen1, Marry de Klerk1, Frank J M F Dor2,3
1Department of Internal Medicine, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, Netherlands.
概括
交换计划 (KEP) 面临一个选择:运送器官或让捐赠者旅行. 器官运输是常见的,尽管潜在的寒冷缺血时间更长,但对移植存活的影响很小. 捐赠者旅行会导致痛苦,并减少参与.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植手术 移植手术
- 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
背景情况:
- 多中心脏交换计划 (KEP) 需要器官运输或捐赠者的旅行.
- 在KEP中对这些后勤方法的可用数据有限.
- 优化KEP参与需要了解器官运输与捐赠者旅行的影响.
研究的目的:
- 在KEP中审查和综合有关器官运输和供体旅行的现有数据.
- 为临床实践制定基于证据的建议.
- 确定减少KEP参与障碍的策略.
主要方法:
- 在KEP中系统地搜索文献,寻找有关器官运输或供体旅行的研究.
- 数据提取和分类为冷缺血时间 (CIT),物流和捐赠者/专业人士的观点.
- 对105篇文章的分析包括了来自547篇选文章的研究.
主要成果:
- 器官运输在全球普遍存在,有可能增加延迟的移植功能,但对移植存活没有明显的影响.
- 运输需要强大的物流和手术室可用性.
- 捐赠者旅行与严重的情感和财务负担有关,并减少了KEP参与 (36%-51%的捐赠者).
- 医疗保健专业人员支持对不愿旅行的捐赠者进行器官运输.
结论:
- 器官运输和捐赠者旅行之间的选择应根据当地环境进行个性化.
- 优先考虑减少KEP参与障碍的重要.
- 促进器官运输和减轻捐赠者的旅行负担可以提高KEP的有效性.
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