Bernhardt Alexander M, Reichenspurner Hermann
Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany.
Curr Opin Organ Transplant. 2014 Oct;19(5):494-9. doi: 10.1097/MOT.0000000000000118.
Increasing waiting lists and declining transplant numbers due to organ shortage are a global problem that needs a multimodal approach to overcome this situation. Extending the criteria for transplantation may be one part of the solution.
There are political efforts to increase the donor rate and change the listing criteria and the allocation process. Recently, the cardiac allocation score was introduced enhancing the factor urgency to the allocation process. Marginal donor organs can be accepted using ex-vivo perfusion strategies. Experimental approaches, such as donation after circulatory death and xenotransplantation, need to be further developed to be applied to humans and increase the pool of available transplant organs.
Organ shortage needs new approaches to overcome the discrepancy between the number of patients on the wait list and performed heart transplantations, reduce wait list mortality and improve long-term outcomes after transplantation.
由于器官短缺导致等待名单增加和移植数量下降是一个全球性问题，需要采取多模式方法来克服这种情况。扩大移植标准可能是解决方案的一部分。
在提高捐赠率、改变列入名单标准和分配流程方面存在政治努力。最近，引入了心脏分配评分，增强了分配过程中的紧急因素。使用体外灌注策略可以接受边缘供体器官。诸如循环死亡后捐赠和异种移植等实验方法需要进一步发展，以便应用于人类并增加可用移植器官的数量。
器官短缺需要新的方法来克服等待名单上的患者数量与心脏移植手术数量之间的差距，降低等待名单上的死亡率，并改善移植后的长期结果。
