克服障碍,扩大墨西哥肝移植的机会
Jose Alonso Avila-Rojo1, Froylan David Martínez-Sánchez1,2, Luis Alejandro Rosales-Rentería1
1Department of Gastroenterology and Hepatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City 14080, Ciudad de Mexico, Mexico.
World journal of transplantation
|December 8, 2025
概括
墨西哥 墨西哥 墨西哥 墨西哥
科学领域:
- 肝病学和移植外科手术
- 公共卫生政策 公共卫生政策
- 器官捐献和移植器官的使用
背景情况:
- 肝移植 (LT) 是末期肝病的唯一治愈选择.
- 墨西哥在LT方面面临重大挑战,包括有限的器官捐赠和不公平的获取,导致与拉丁美洲相比移植率较低.
- 现有的基础设施和资源限制阻碍了LT计划的广泛扩张.
研究的目的:
- 综合审查墨西哥肝移植的现状.
- 分析历史趋势,确定关键障碍,并探索增强LT服务的机会.
- 评估COVID-19大流行对LT计划的影响.
主要方法:
- 采用了一个叙事审查方法.
- 数据来源于墨西哥国家移植中心 (Centro Nacional de Trasplantes),同行评审文献和全球基准.
- 分析的重点是移植量,捐赠者类型,疾病病因,机构差异和流行病影响.
主要成果:
- 墨西哥的肝移植活动从1999年的25个增加到2023年的297个,但总体上仍然很低.
- 移植服务高度集中 (在墨西哥城超过68%),只有有限的中心提供大量的移植服务.
- 已故捐赠占主导地位,而活着的捐赠很少;国家等待名单缺乏以优先级为基础的分配系统. 随着COVID-19的流行,公共部门的项目受到严重破坏.
结论:
- 墨西哥的肝移植系统受到地理,监管和资源限制的限制.
- 需要进行重大改革,以扩大捐赠者的可用性,集中分配系统和标准化护理.
- 实施输液等先进技术,并采用循环死亡后捐赠等策略,可以改善结果和获取.
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