Rikako Oki, Ingrid Rocha, Saleh Al-Juburi, Luckshi Rajendran, Emily Kerby, Adhnan Mohamed, Abbas Al-Kurd, Ahmed Nassar, Dean Y Kim, Atsushi Yoshida, Marwan Abouljoud, Shunji Nagai
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引用次数: 0
摘要
在肝脏和肾脏同时移植（SLKT）中使用机器灌注（MP）可以增加器官的使用。我们使用联合器官共享网络数据库分析了2015年至2024年间进行的6,956例SLKT。主要结果是肾脏和肝脏移植的1年生存率。收集供体类型和肝脏和/或肾脏的MP使用情况，并评估其与预后的关系。循环性死亡供者（DCD）捐赠的SLKT从2015年的4.5%增加到2023年的16%。肾供者概况指数（KDPI）中位数从2015年的23%上升到2023年的28%。肾脏和肝脏的MP用量也分别从21%增加到51%和0%-17%。KDPI bb0 85%是无肾MP组1年肾移植衰竭的独立危险因素[HR 2.03, 95% CI 1.20-3.44, p = 0.009]，而肾MP组则不是。无肝MP组DCD是1年肝移植失败的独立危险因素[HR 1.56, 95% CI 1.19-2.03, p = 0.001]，而有肝MP组则不是。两种器官的MP可能有助于扩大SLKT的供体池，而不会影响移植后的结果。
The Individual Impact of Machine Perfusion on Liver and Kidney on Donor Expansion in Simultaneous Liver and Kidney Transplantation.
Machine perfusion (MP) use for both organs can increase organ usage in simultaneous liver and kidney transplantation (SLKT). We analyzed 6,956 SLKT performed between 2015 and 2024 using the United Network for Organ Sharing database. The primary outcomes were the 1-year graft survival for kidney and liver. Donor types and MP use for liver and/or kidney were captured and associations with outcomes were evaluated. SLKT from Donation after circulatory death donors (DCD) increased from 4.5% in 2015 to 16% in 2023. The median Kidney Donor Profile Index (KDPI) has increased from 23% in 2015 to 28% in 2023. MP use for kidney and liver also increased from 21% to 51% and 0%-17%, respectively. KDPI >85% was an independent risk factor of 1-year kidney graft failure in the no kidney MP group [HR 2.03, 95% CI 1.20-3.44, p = 0.009], but not in the kidney MP group. DCD was found to be an independent risk factor of 1-year liver graft failure in the no liver MP group [HR 1.56, 95% CI 1.19-2.03, p = 0.001], but not in the liver MP group. MP for both organs may contribute to expanding the donor pool for SLKT without compromising post-transplant outcomes.
期刊介绍：
The aim of the journal is to serve as a forum for the exchange of scientific information in the form of original and high quality papers in the field of transplantation. Clinical and experimental studies, as well as editorials, letters to the editors, and, occasionally, reviews on the biology, physiology, and immunology of transplantation of tissues and organs, are published. Publishing time for the latter is approximately six months, provided major revisions are not needed. The journal is published in yearly volumes, each volume containing twelve issues. Papers submitted to the journal are subject to peer review.
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