The Potential Impact of Using Donations After Cardiac Death on the Liver Transplantation Program and Waiting List in the State of Sao Paulo, Brazil
The Potential Impact of Using Donations After Cardiac Death on the Liver Transplantation Program and Waiting List in the State of Sao Paulo, Brazil
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DOI：
10.1002/lt.21611
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发表时间：
2008-12-01
影响因子：
4.6
通讯作者：
Massad, Eduardo
中科院分区：
文献类型：
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作者：
Chaib, Elleazar;Massad, Eduardo
肝移植于1968年在圣保罗大学医学院首次进行。从那时起，等待肝移植的病人名单以每月150个新病例的速度增加。从1988年到2004年，肝移植本身增加了1.84倍（从160增加到295）。然而，肝脏等待名单上的患者数量增加了2.71倍（从553人增加到1500人）。因此，肝脏等待名单上的死亡人数从321人上升到671人，增加了2.09倍。我们应用数学模型来分析使用心脏死亡后捐赠（DCD）政策对我们的肝移植计划和等待名单的潜在影响。2004年，我们州有5100人死于事故和其他暴力原因;其中只有295人是肝移植的捐赠者。该模型假设这些移植物中有5%为DCD。我们发现，假设每年将进行248例额外的肝移植，如果使用DCD，肝移植等待名单的大小相对减少27%。总之，在我们的移植计划中使用DCD将减少我们肝移植等待名单的压力，至少减少27%。根据这一模式，预计在今后20年内避免的死亡人数约为41 487人。肝移植14：1732-1736，2008。(C)2008年AASLD。
Liver transplantation was first performed at the University of Sao Paulo School of Medicine in 1968. Since then, the patient waiting list for liver transplantation has increased at a rate of 150 new cases per month. Liver transplantation itself rose 1.84-fold (from 160 to 295) from 1988 to 2004. However, the number of patients on the liver waiting list jumped 2.71-fold (from 553 to 1500). Consequently, the number of deaths on the liver waiting list moved to a higher level, from 321 to 671, increasing 2.09-fold. We have applied a mathematical model to analyze the potential impact of using a donation after cardiac death (DCD) policy on our liver transplantation program and on the waiting list. Five thousand one hundred people died because of accidents and other violent causes in our state in 2004; of these, only 295 were donors of liver grafts that were transplanted. The model assumed that 5% of these grafts would have been DCD. We found a relative reduction of 27% in the size of the liver transplantation waiting list if DCD had been used by assuming that 248 additional liver transplants would have been performed annually. In conclusion, the use of DCD in our transplantation program would reduce the pressure on our liver transplantation waiting list, reducing it by at least 27%. On the basis of this model, the projected number of averted deaths is about 41,487 in the next 20 years. Liver Transpl 14:1732-1736, 2008. (C) 2008 AASLD.