Matching the Market for Heart Transplantation.
Matching the Market for Heart Transplantation.
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DOI：
10.1161/circheartfailure.115.002679
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发表时间：
2016-04
期刊：
影响因子：
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通讯作者：
Hsich EM
中科院分区：
文献类型：
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作者：
Hsich EM
心脏移植是D期心力衰竭患者最有效的治疗方法，患者的平均预期寿命约为10-15年。不幸的是，许多患者死在等待名单上，希望有生存的机会。这艘“救生艇”救不了所有人。十年来，捐赠者群体保持相对稳定，而心脏移植候选人的数量有所上升。由于心脏移植的标准几乎没有绝对的禁忌症，潜在的接受者通常有许多并存的疾病，而且年龄更大。与男性、白人患者以及患有缺血性或扩张性心肌病的患者相比，女性、西班牙裔、限制性心脏病和先天性心脏病患者在等待心脏移植期间死亡的可能性更大。为了更好地匹配市场，我们需要1)增加捐赠者池，2)减少等待名单，3)改善分配制度。这篇综述文章讨论了所有三种选择，将美国的战略与其他国家的战略进行了比较。
Heart transplantation is the most effective therapy for patients with Stage D heart failure with a median life expectancy of about 10-15 years. Unfortunately, many patients die on the waiting list hoping for a chance of survival. The “life boat” cannot rescue everyone. Over a decade, the donor pool has remained relatively stable while the number of heart transplant candidates has risen. Potential recipients often have many co-morbidities and are older since the criteria for heart transplantation has few absolute contraindications. Women, Hispanics, and patients with restrictive heart disease and congenital heart disease are more likely to die while awaiting heart transplantation than men, White patients, and those with either ischemic or dilated cardiomyopathy. To better match the market we need to 1) increase the donor pool, 2) reduce the waitlist, and 3) improve the allocation system. This review article addresses all three options comparing strategies in the United States to those in other countries.