欧洲关于"边际质量"捐赠肝脏的政策
D F Mirza1, B K Gunson, R F Da Silva
1Liver and Hepatobiliary Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.
Lancet (London, England)
|November 26, 1994
概括
肝移植中心拒绝接受可行的供体肝脏. 边缘捐赠者移植的存活率与标准移植的存活率相似,这表明目前的标准太严格了.
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:
- 捐赠肝脏短缺需要扩大捐赠者标准.
- 边缘供体肝脏往往因为被认为不适合而被拒绝.
- 评估边际捐赠器官的有用性至关重要.
研究的目的:
- 评估从边缘捐赠者获得的肝移植的功能和结果.
- 评估欧洲移植中心对使用边际供体肝脏的态度.
- 在肝移植中识别最佳器官利用的潜在障碍.
主要方法:
- 在18个月的时间里,对30个边缘捐赠者的肝移植和183个标准捐赠者的肝移植进行了回顾性分析.
- 早期移植功能 (1日AST) 和1年患者/移植存活率的比较.
- 对60个欧洲肝脏移植集团中心的调查,关于边际捐赠者的接受/拒绝率.
主要成果:
- 与对照组相比,边缘供体移植显示出令人满意的早期功能,AST和AST峰值在第一天略有增加.
- 在边际和标准供体组之间,一年的移植存活率 (72% vs 73%) 和患者存活率 (80% vs 82%) 类似.
- 观察到大量不愿意接受边际捐赠者,中位数拒绝率为7/30,尽管大型中心的选择性较低.
结论:
- 边际供体肝脏可以达到与标准移植相似的结果,挑战现有的限制性供体标准.
- 欧洲移植中心对边缘捐赠肝脏的拒绝率很高,导致不必要的器官浪费.
- 修订供体选择标准可以增加供体肝脏的可用性,提高移植率.
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