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演变中的脏捐赠者池塑造了移植存活的结果
Kaufman Daniel M1, Perkins James D2,3, Bakthavatsalam Ramasamy2
1Department of Surgery, Division of Transplant Surgery, St. Vincent Hospital, Indianapolis, Indiana, USA, stvincenthospital.com.
Journal of transplantation
|February 26, 2026
概括
美国脏捐赠者池正在转向高风险的捐赠者,包括老年人和循环死亡 (DCD) 后捐赠的捐赠者. 这一趋势与移植移植移植存活率下降的早期迹象有关.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植手术 移植手术
- 公共卫生 公共卫生
背景情况:
- 美国已故脏捐赠者的组成正在发生变化.
- 年轻,过量死亡的捐赠者减少,老年捐赠者增加,那些患有并发症 (高血压,糖尿病) 和循环死亡 (DCD) 后的捐赠者.
研究的目的:
- 分析美国已故脏捐赠者池的变化.
- 评估这些捐赠者特征对移植结果的影响,特别是移植存活率.
主要方法:
- 分析了2018-2024年101,550名已故脏捐赠者和108,611名一次性脏移植的数据,使用了器官采购和移植网络 (OPTN) 的数据.
- 通过细分回归分析评估的捐助者趋势.
- 使用卡普兰-梅尔曲线和多变量考克斯比例危险模型评估的移植存活率.
主要成果:
- 过量死亡的捐赠者从16.7% (2022) 减少到10.5% (2025年第一季度).
- 循环死亡 (DCD) 捐赠者捐赠后的捐赠增加到所有已故捐赠者的近50%.
- 与2018-2022年相比,未经调整的死亡审查的移植存活率在2024年下降 (97.0%对97.6%).
- 高风险的捐赠因子 (DCD,年龄较大,高血压,糖尿病,长期感冒缺血症) 独立地与移植损失有关.
结论:
- 美国脏捐赠者池越来越多地由高风险的捐赠者组成.
- 早期证据表明,移植移植的生存率下降.
- 优化器官保存和分配策略对于维持移植成功率至关重要.
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