Practices and Perceptions of Living Donor Liver Transplantation, Nondirected Donation, and Liver Paired Exchange: A National Survey.
Practices and Perceptions of Living Donor Liver Transplantation, Nondirected Donation, and Liver Paired Exchange: A National Survey.
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DOI：
10.1002/lt.26384
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发表时间：
2022-05
影响因子：
4.6
通讯作者：
Brown, Robert S., Jr.
中科院分区：
文献类型：
--
作者：
Kaplan, Alyson;Rosenblatt, Russell;Jackson, Whitney;Samstein, Benjamin;Brown, Robert S., Jr.
活体肝移植（LDLT）在美国仍然没有得到充分利用。LDLT的障碍和接受非定向活体肝脏捐献（ND-LLD）和肝脏配对交换（LPE）尚不清楚。对99个独特的移植项目（56个LDLT项目和43个非LDLT项目）的医疗和外科主任进行了调查，以深入了解LDLT的看法和实践以及所使用的供体类型。应答率为84%。大多数LDLT计划（65%）报告执行ND-LLD，但关于分配和需要对这些捐助者进行额外评估的意见不一。只有少数LDLT项目报告进行了LPE（12%），但大多数项目（78%）将对跨机构LPE开放，除非存在后勤障碍。LDLT和非LDLT项目在LDLT的感知障碍方面存在显著差异，LDLT项目主要报告供体和受体因素，非LDLT项目报告机构因素（p<0.001）。了解LDLT、ND-LLD和LPE的认知和实践对于帮助LDLT的发展非常重要。
Living donor liver transplant (LDLT) remains under-utilized in the United States. Barriers to LDLT and acceptance of non-directed living liver donation (ND-LLD) and liver paired exchange (LPE) are unclear. The medical and surgical directors of 99 unique transplant programs (56 LDLT programs and 43 non-LDLT programs) were surveyed to gain insight into perceptions and practices of LDLT and types of donors utilized. The response rate was 84%. Most LDLT programs (65%) reported performing ND-LLD, though opinions regarding allocation and the need for additional evaluation of these donors were mixed. Only a minority of LDLT programs reported performing LPE (12%), but most programs (78%), would be open to cross-institutional LPE barring logistical barriers. There were significant differences between LDLT and non-LDLT programs with regard to perceived barriers to LDLT with LDLT programs reporting mainly donor and recipient factors and non-LDLT programs reporting institutional factors (p<0.001). Understanding perceptions and practices of LDLT, ND-LLD, and LPE is important to aid in the growth of LDLT.
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