在DBD和DCD捐赠者中,三个肺捐赠者得分和肺接受度之间的关联
Fabian Iten1, Julius Weiss1, Simon Schwab1
1Swisstransplant, Swiss National Foundation of Organ Donation and Transplantation, Bern, Switzerland.
概括
瑞士的肺接受实践与捐赠者得分一致,如Oto,Eurotransplant和苏黎世捐赠者得分. 然而,这些得分有局限性,这表明需要一个新的瑞士预测工具来更好地利用器官.
科学领域:
- 移植免疫学 移植免疫学
- 胸部外科手术 胸部外科手术
- 器官供体管理器官供体管理
背景情况:
- 扩展标准供体 (ECD) 对于解决肺移植器官短缺问题至关重要.
- 评估肺移植质量和优化捐赠者选择是关键的挑战.
研究的目的:
- 评估瑞士肺接受实践与三个验证的捐赠者得分之间的关联:Oto得分,欧洲移植得分 (ET) 和苏黎世捐赠者得分 (ZDS).
- 在脑死亡 (DBD) 后的已故捐赠者和循环死亡 (DCD) 后的已故捐赠者场景中评估这些得分的辨别能力.
主要方法:
- 在2014年7月至2024年6月期间对1515位已故捐赠者的分析.
- 使用后勤回归和接受器运行特征曲线 (AUC-ROC) 下面区域分析.
- 由于临床数据有限,调整了Oto (aOto) 和ET (aET) 评分.
主要成果:
- 所有三个分数 (aOto,aET,ZDS) 都显示出与肺接受度的关联.
- AUC值表示可接受到适度的区分能力 (0.75为aOto,0.70为aET,0.77为ZDS).
- 与DBD捐赠者相比,DDD捐赠者接受的可能性较低.
结论:
- 现有的捐赠者得分作为瑞士肺部接受的独立模型具有局限性.
- 需要一个新的,适用于全国的瑞士预测工具,整合捐助者和接受者因素.
- 改进的工具可以提高捐赠者-接受者匹配,并增加肺移植活动.
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