Disparities in heart and lung transplantation.
Disparities in heart and lung transplantation.
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DOI：
10.1097/mot.0000000000000916
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发表时间：
2021-10-01
影响因子：
2.2
通讯作者：
Hsich E
中科院分区：
文献类型：
--
作者：
Tsuang W;Khedraki R;Hsich E
心胸移植是终末期心肺疾病的最终治疗方法。在为这一人群提供服务时，必须同时了解和解决获取和护理方面的差异。在心脏和肺移植中存在性别、种族、地理、年龄和潜在疾病差异。与男性相比，女性在心脏和肺移植方面的等待期存活率降低，但移植后存活率提高。黑人患者在心脏移植后的预后比其他种族患者差。地域差异影响了接受心脏或肺移植的可能性，越来越多的高龄患者寻求移植使生存效益的讨论复杂化。最后，潜在疾病已经影响到心脏和肺移植的结果，现在被纳入分配系统。尽管心肺移植存在一些差异，但医疗技术的进步、供体器官分配政策的变化以及患者选择经验的增加将如何影响这些问题，仍有待观察。
Cardiothoracic transplantation is the definitive therapy for end stage heart and lung disease. In service to this population, disparities in access and care must be simultaneously understood and addressed. There are sex, race, geographic, age, and underlying disease disparities in both heart and lung transplantation. Women have reduced waitlist survival but improved post-transplant survival when compared to men for both heart and lung transplantation. Black patients have worse outcome compared to other races post-heart transplant. Geographic disparities impact the likelihood of receiving heart or lung transplant and the growing number of patients with advanced age seeking transplant complicates discussions on survival benefit. Finally, underlying disease has affected outcomes for both heart and lung transplant and now are incorporated into the allocation system. Though heart and lung transplantation have several existing disparities, it remains to be seen how advancements in medical technology, changes in donor organ allocation policies, and growing experience in patient selection will impact these concerns.