美国血管化复合组织同种异体移植捐献的现状。
The landscape of vascularized composite allograft donation in the United States.
机构信息
Department of Surgery, Division of Transplantation, Johns Hopkins School of Medicine.
Department of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.
出版信息
Curr Opin Organ Transplant. 2019 Dec;24(6):699-704. doi: 10.1097/MOT.0000000000000703.
PURPOSE OF REVIEW
Vascularized composite allograft (VCA) donation and transplantation has now demonstrated feasibility and impact to the lives of patients suffering from devastating and traumatic injury. This review summarizes the current landscape of VCA donation in the United States.
RECENT FINDINGS
VCA donations are nonlife-saving allografts, for nonlife-saving transplants - and therefore, conservative donor selection focused on the optimization of donors for the lowest risk to transplant recipients is paramount. VCA donors in the United States are a demographically and clinically diverse group that largely reflects the characteristics of the VCA candidates waiting for transplants. Public opinion about VCA donation is generally supportive, but has lower support for VCA transplants than for solid organ transplants.
SUMMARY
As an emerging area of transplantation, VCA donation is evolving in the United States with growing interest by the public, and those suffering from catastrophic injury for which reconstructive transplantation may offer excellent outcomes and a high quality of life.
目的综述
带血管复合组织同种异体移植物(VCA)的捐献和移植已证实具有可行性,并且能改善遭受严重创伤和破坏性损伤患者的生活。本文综述了美国目前 VCA 捐献的现状。
最近发现
VCA 捐献是非救命性同种异体移植物,用于非救命性移植,因此,重点是对供者进行保守选择,使移植受者面临的风险降至最低,这一点至关重要。美国 VCA 供者是一个在人口统计学和临床方面具有多样性的群体,这在很大程度上反映了等待移植的 VCA 候选者的特征。公众对 VCA 捐献的总体看法是支持的,但对 VCA 移植的支持率低于对实体器官移植的支持率。
总结
作为移植领域的一个新兴领域,美国的 VCA 捐献正在发展,公众和那些遭受灾难性损伤的人越来越感兴趣,因为重建性移植可能带来极好的结果和高质量的生活。