多器官移植的现状及其对未来实践和政策的影响。

IF 2 3区 医学 Q2 UROLOGY & NEPHROLOGY
Scott G. Westphal, Eric D. Langewisch, Clifford D. Miles
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引用次数: 1

摘要

在肝移植和心脏移植候选患者中,肾功能不全的发生率有所增加,这反映了患者群体的变化和优先考虑最迫切候选患者的分配政策。移植前肾功能障碍的加重导致多器官移植(MOT)的应用大幅增加。由于可用的已故供体肾脏短缺,MOT使用的增加有可能使单独肾脏移植候选人处于不利地位,因为目前的分配政策通常优先考虑MOT候选人,而不是所有单独肾脏移植候选人。在这篇综述中,肾脏疾病对肝移植和心脏移植候选人的影响进行了综述,并讨论了目前用于分配器官的政策。研究了与交通工具分配有关的重要道德考虑因素,并考虑了未来可能改善交通工具政策公平性和效用的政策修改。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Current State of Multiorgan Transplantation and Implications for Future Practice and Policy

The incidence of kidney dysfunction has increased in liver transplant and heart transplant candidates, reflecting a changing patient population and allocation policies that prioritize the most urgent candidates. A higher burden of pretransplant kidney dysfunction has resulted in a substantial rise in the utilization of multiorgan transplantation (MOT). Owing to a shortage of available deceased donor kidneys, the increased use of MOT has the potential to disadvantage kidney-alone transplant candidates, as current allocation policies generally provide priority for MOT candidates above all kidney-alone transplant candidates. In this review, the implications of kidney disease in liver transplant and heart transplant candidates is reviewed, and current policies used to allocate organs are discussed. Important ethical considerations pertaining to MOT allocation are examined, and future policy modifications that may improve both equity and utility in MOT policy are considered.

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来源期刊
Advances in chronic kidney disease
Advances in chronic kidney disease 医学-泌尿学与肾脏学
自引率
3.40%
发文量
69
审稿时长
11.1 weeks
期刊介绍: The purpose of Advances Chronic Kidney Disease is to provide in-depth, scholarly review articles about the care and management of persons with early kidney disease and kidney failure, as well as those at risk for kidney disease. Emphasis is on articles related to the early identification of kidney disease; prevention or delay in progression of kidney disease
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