在移植之前评估固体器官捐献者的感染:对临床实践指南的系统审查
Chanel H Chong1,2, Thida Maung Myint1,3, Ryan Gately4
1Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
Transplantation
|March 10, 2026
概括
对于固体器官供体感染查的临床实践指南显示,对于常见的病原体是一致的,但对于新出现的病原体是不同的. 透明度和现实世界的评估对于优化捐赠器官使用和患者安全至关重要.
科学领域:
- 移植免疫学 移植免疫学
- 传染病流行病学 传染病流行病学
- 临床实践指导方针的制定.
背景情况:
- 在固体器官移植中,来自捐赠者的感染构成重大风险.
- 临床实践指南旨在标准化捐赠者评估,但表现出中心间的变化.
- 这项研究批判性地评估了固体器官供体感染评估现有指南的质量和一致性.
研究的目的:
- 评估实体器官供体感染评估临床实践指南的质量和一致性.
- 总结对查和接受器官捐献者的建议.
- 确定捐赠者感染指南的共识和变化的领域.
主要方法:
- 系统地搜索电子数据库和专业组织网站的指导方针和共识声明.
- 使用研究和教育指南评估II (AGREE II) 工具进行方法质量评估.
- 文本综合比较建议,并总结各种各样的捐赠者和器官类型的发现.
主要成果:
- 分析了19个临床实践指南和19个共识声明,涵盖了各种捐赠者类型,器官和感染类别.
- 大多数指南强调范围和目的,不太关注适用性和开发严格性.
- 对常见感染 (例如,HBV,HCV,HIV,TB) 观察到一致的建议,对于新出现的感染或低于最佳的查测试,观察到的变化.
结论:
- 对已确定的感染的建议在指导方针中基本一致.
- 在存在不确定性的情况下,需要加强证据综合的透明度.
- 对指导方针实施的现实世界评估至关重要,以平衡最大限度地利用器官并最大限度地减少感染传播.
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