从边缘到常规的旅程:意大利的单一中心体验使用DCD用于肝移植的经验
Guido Fallani1,2, Alberto Stocco1,2, Giorgia Radi1,3
1Hepato-biliary and Transplant Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti, 9, 40138, Bologna, Italy.
Updates in surgery
|March 10, 2026
概括
在意大利心血管死亡确定 (DCD) 肝移植后的捐赠显示出稳定的结果,尽管捐赠者和接受者风险增加. 项目经验和改造策略有效地减轻了与DCD相关的风险.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植手术 移植手术
- 器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器
背景情况:
- 心血管决定死亡 (DCD) 后的捐赠扩大了肝脏捐赠者池,但面临着长期温暖缺血和较差的结果等挑战.
- 意大利在DCD捐赠者中强制实施辅风期会增加风险.
- 这项研究检查了意大利中心的DCD肝移植趋势,以评估经验和康复的影响.
研究的目的:
- 为了评估DCD肝移植结果的趋势,随着时间的推移,在意大利一个大规模的中心.
- 确定积累的经验和先进的康复策略是否影响了结果.
- 在具有挑战性的监管环境中评估DCD肝移植的安全性和有效性.
主要方法:
- 从2016年到2023年,对成人DCD肝移植的回顾性分析.
- 基于捐赠者/接受者特征,输液策略和缺血时间的早期 (2016-2021) 和晚期 (2022-2023) 周期的比较.
- 使用线性回归评估的时间趋势.
主要成果:
- 包括75名DCD肝移植者;晚期接受者和捐赠者呈现较高的风险概况 (例如,更晚期的肝病,老年捐赠者,更高的风险评分).
- 低温氧化输液 (HOPE) 持续时间增加,和总缺血时间线性减少与程序成熟.
- 尽管捐赠者和接受者的复杂性增加,早期的全移植功能障碍,胆道并发症,再移植率和存活率在期间之间保持稳定.
结论:
- 在高风险的监管环境中,DCD肝移植结果保持稳定,即使捐赠者和接受者的复杂性越来越高.
- 程序成熟,缺血时间最小化和HOPE有效地减轻了与DCD相关的风险.
- 这些发现支持在具有挑战性的临床环境中更广泛,更安全地利用DCD肝移植.
关键词:
在DCD肝移植手术中.在心血管疾病确定死亡后的捐赠.扩展标准 捐助者 捐赠者低温氧化 perfusion 是一种氧化 perfusion 的方法.边际捐赠者是边际的诺姆热区域 perfusion 区域 perfusion 区域 perfusion 区域 perfusion 区域 perfusion 区域 perfusion 区域 perfusion 区域 perfusion 区域 perfusion 区域 perfusion 区域 perfusion 区域 perfusion 区域更多相关视频
09:54Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
2.4K
05:25Author Spotlight: Advancements and Challenges in Machine Perfusion for Liver Transplantation
Published on: June 14, 2024
1.1K
相关概念视频
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
414
Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in...
414
Kidney Transplant I: Introduction
827
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
827
Kidney Transplant II: Surgical Procedure
926
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
926
Cirrhosis I: Introduction
28
Cirrhosis is a chronic, irreversible liver disease characterized by the widespread replacement of healthy liver tissue with fibrotic scar tissue and the formation of regenerative nodules.Etiology of cirrhosisCirrhosis results from sustained liver injury that triggers progressive fibrosis and structural remodeling. The underlying causes are diverse, encompassing common and less frequent clinical conditions. Regardless of the origin, all causes lead to chronic inflammation, hepatocyte loss, and...
28
