异体造血细胞与器官移植的异同与借鉴,指导全球健康战略。

IF 1.9 4区 医学 Q2 SURGERY
Hildegard T Greinix, Arthur Matas, Mickey B C Koh, Lydia Foeken, Nina Worel, Amanda Vinson, Hassan Ibrahim, Deirdre Sawinski, Adriana Seber, Maryam Valapour, Yoshiko Atsuta, Thilo Mengling, John Lake, Thomas Wekerle, Daniel Weisdorf
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引用次数: 0

摘要

背景:同种异体造血细胞移植(HCT)和实体器官移植(SOT)已经发展成为许多严重先天性和获得性疾病的成功治疗方法。两者都使用源自人类的医疗产品,因此应具有总体监管框架。两者都需要在供体选择、供体/受体匹配、免疫抑制和长期护理方面做出关键决策,所有这些任务最好由训练有素、高度专业化的多学科团队来完成。两者的成功都需要坚定的机构和政府的支持。尽管实施SOT的主要障碍是缺乏合适的器官,但进入移植中心是HCT的主要限制,这仍然是一个高度专业化、复杂、资源密集和昂贵的医疗程序。方法和结果:在这里,我们描述了HCT和SOT的主要适应症,它们在供体选择、移植前治疗、移植后免疫抑制的强度和持续时间方面的异同,它们的主要并发症,以及活体供体捐献的后果。结论:讨论了改善全球获得HCT和SOT的战略,以及这一高度创新的医学领域的未来发展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Similarities and Differences Between Allogeneic Hematopoietic Cell and Organ Transplantation and What We Can Learn From Each Other to Guide Global Health Strategy.

Background: Allogeneic hematopoietic cell transplantation (HCT) and solid organ transplantation (SOT) have evolved into successful, curative treatments for many severe congenital and acquired diseases. Both use medical products of human origin and should therefore have overarching regulatory frameworks. Both require critical decisions about donor selection, donor/recipient matching, immunosuppression, and long-term care, all tasks best performed by a trained, highly specialized multidisciplinary team. Both need committed institutions and governmental support for their success. Whereas the main barrier for performing SOT is the lack of suitable organs, access to a transplant center is the main limitation for HCT, which remains a highly specialized, complex, resource-intensive, and costly medical procedure.

Methods and results: Here, we describe the main indications for HCT and SOT, their similarities and differences regarding donor selection, treatment prior to transplant, intensity and duration of immunosuppression after transplantation, their main complications, and consequences of donation for living donors.

Conclusions: Strategies to improve worldwide access to HCT and SOT are discussed, as well as future developments in this highly innovative field of medicine.

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来源期刊
Clinical Transplantation
Clinical Transplantation 医学-外科
CiteScore
3.70
自引率
4.80%
发文量
286
审稿时长
2 months
期刊介绍: Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.
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