人类卵巢组织的运输网络对于生育力保存的成功是不可或缺的。
A transportation network for human ovarian tissue is indispensable to success for fertility preservation.
机构信息
Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan.
Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan.
出版信息
J Assist Reprod Genet. 2017 Nov;34(11):1469-1474. doi: 10.1007/s10815-017-1022-3. Epub 2017 Sep 2.
PURPOSE
The purpose of this study was to examine the efficacy of an ovarian tissue transportation network for fertility preservation (FP) for cancer patients in Japan.
METHODS
PubMed was searched for papers on transportation of human ovarian tissue for FP. We analyzed population, area, number of cancer patients for ovarian tissue cryopreservation (OTC), quality control/assessment and safety, cost of a cryopreservation center for the building for 30 years, and medical fees of cancer patients (operation, cryopreservation, and storage of ovarian tissue).
RESULTS
More than twenty babies have been born in Denmark and Germany through a transportation system. Up to 400 new patients a year need OTC. The fees for removal, cryopreservation, and storage for 5 years, and transplantation of ovarian tissue are around €5,000, €4,000, and €5,000, respectively. It costs more than €5 million to establish and maintain one cryopreservation center for 30 years. If we have a few cryopreservation centers in Japan, we can cryopreserve 400 patients' ovarian tissue per year by safer slow freezing and maintain quality control/assessment. We need to lighten the patients' burden for easy to use FP by a government subsidy and medical insurance coverage.
CONCLUSIONS
This model has been termed the Danish model ("the woman stays - the tissue moves"). This is truly patient-centered medicine. We can have maximum effects with the minimum burden. A transportation network like those of Denmark and Germany is the best strategy for FP in Japan. It may be the best system for cancer patients, medical staff, and the Ministry of Health, Labor, and Welfare.
目的
本研究旨在考察日本癌症患者生育力保存（FP）用卵巢组织运输网络的疗效。
方法
在 PubMed 上检索关于用于 FP 的人类卵巢组织运输的论文。我们分析了人口、面积、用于卵巢组织冷冻保存（OTC）的癌症患者数量、质量控制/评估和安全性、冷冻保存中心 30 年建筑成本以及癌症患者的医疗费用（手术、卵巢组织冷冻保存和储存）。
结果
通过运输系统，丹麦和德国已经诞生了二十多个婴儿。每年需要 OTC 的新患者超过 400 人。取出、冷冻保存和储存 5 年以及卵巢组织移植的费用分别约为 5000 欧元、4000 欧元和 5000 欧元。建立和维持一个冷冻保存中心 30 年的费用超过 500 万欧元。如果日本有几个冷冻保存中心，我们可以通过更安全的慢速冷冻保存每年 400 名患者的卵巢组织，并保持质量控制/评估。我们需要通过政府补贴和医疗保险覆盖来减轻患者对易于使用 FP 的负担。
结论
这种模式被称为丹麦模式（“女性留下-组织移动”）。这是真正以患者为中心的医学。我们可以用最小的负担获得最大的效果。丹麦和德国那样的运输网络是日本 FP 的最佳策略。它可能是癌症患者、医务人员和厚生劳动省的最佳系统。
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