农村社区的等待名单和移植后结果与目前的心脏移植分配
Mohammad U Ahmed1,2, Michael Dickinson1,2, David Fermin1,2
1Corewell Health Frederik Meijer Heart and Vascular Institute, Grand Rapids, MI.
JHLT open
|February 24, 2026
概括
2018年心脏移植政策改善了等候名单的结果,但农村居民在分配后面临更高的死亡/删除率. 对于农村和城市患者来说,移植率和生存率仍然相似.
科学领域:
- 心脏病学 心脏病学
- 移植医学 移植医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 2018年器官采购和移植网络 (OPTN) 的心脏移植分配政策旨在改善等待列表的结果.
- 尽管政策有所改善,但农村和城市人口之间的心脏移植 (HT) 获取和结果的持续差异需要调查.
研究的目的:
- 评估2018年OPTN心脏移植分配政策对农村社区和城市社区等待名单和移植后结果的影响.
- 根据地理居住地,识别心脏移植结果的潜在差异.
主要方法:
- 从OPTN数据库中分析了2014年至2021年期间在HT上列出的26,450名患者.
- 根据邮政编码将患者分类为农村或城市.
- 使用Kaplan-Meier方法计算死亡/删除和移植的累积发病率 (CI),以及移植后的存活率.
主要成果:
- 根据新政策,农村和城市社区的等候名单死亡/删除数量减少,HT率增加.
- 在目前的分配中,与城市居民相比,农村居民的死亡/删除频率更高 (p=0.01).
- 农村和城市群体之间的HT累积发病率或移植后存活率没有显著差异.
结论:
- 虽然2018年政策总体上降低了等候名单死亡率,但农村居住与死亡/退出等待名单的风险不成比例地高.
- 根据农村或城市的地位,没有发现移植率或移植后生存率的差异.
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