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脑死亡器官捐献者伴中枢神经系统肿瘤的捐献安全性:韩国移植结局分析。

Safety of Donation From Brain-dead Organ Donors With Central Nervous System Tumors: Analysis of Transplantation Outcomes in Korea.

机构信息

Korea Organ Donation Agency, Seodaemun-gu, Seoul, Republic of Korea.

Department of Surgery and Transplantation Research Institute, Seoul National University College of Medicine, Jongno-gu, Seoul, Republic of Korea.

出版信息

Transplantation. 2020 Mar;104(3):460-466. doi: 10.1097/TP.0000000000002994.

Abstract

BACKGROUND

This study aims to verify the condition of recipients of solid organs from donors with central nervous system (CNS) tumors and determine the risk of disease transmission due to transplantation.

METHODS

Twenty-eight brain-dead organ donors with CNS tumors and 91 recipients who received solid organs from January 1, 2005, to December 31, 2014 in Korea were investigated using the Korean Network of Organ Sharing data.

RESULTS

Of the 36 recipients of organs from the 11 donors whose pathological results were not verified, 4 developed the following tumors: renal cell carcinoma, carcinoma in situ of the cervix uteri, B-cell lymphoma, and colon cancer. Among 51 recipients from 17 donors with CNS tumor, no recipient had the same tumor as the donors. Six were classified as high-risk donors according to the World Health Organization classification, and 14 recipients from these donors did not develop tumor after transplantation. The remaining 11 donors were classified as low-risk donors according to the World Health Organization classification but as high-risk donors according to the Malignancy Subcommittee of the Disease Transmission Advisory Committee of the Organ Procurement and Transplantation Network/United Network for Organ Sharing. Of the 37 recipients, 3 had recurring hepatocellular carcinoma with lung and bone metastases, thyroid cancer, and Kaposi's sarcoma after transplantation.

CONCLUSIONS

The risk of disease transmission due to organ transplantation from donors with CNS tumors was very low. Thus, organ donation from such donors should be promoted actively to expand the donor range.

摘要

背景

本研究旨在验证来自中枢神经系统(CNS)肿瘤供者的实体器官受者的状况,并确定因移植而导致疾病传播的风险。

方法

使用韩国器官共享网络的数据,对 2005 年 1 月 1 日至 2014 年 12 月 31 日期间来自韩国的 28 例脑死亡器官供者和 91 例接受来自 CNS 肿瘤供者的实体器官的受者进行了调查。

结果

在未对 11 例供者的病理结果进行验证的 36 例器官受者中,有 4 例发生了以下肿瘤:肾细胞癌、子宫颈原位癌、B 细胞淋巴瘤和结肠癌。在 51 例来自 17 例 CNS 肿瘤供者的受者中,没有受者与供者患有相同的肿瘤。根据世界卫生组织分类,有 6 例被归类为高危供者,而这 6 例供者的 14 例受者在移植后未发生肿瘤。其余 11 例供者根据世界卫生组织分类被归类为低危供者,但根据器官采购与移植网络/联合器官共享网络疾病传播咨询委员会恶性肿瘤小组委员会的分类则被归类为高危供者。在 37 例受者中,有 3 例在移植后出现了复发性肝细胞癌伴肺和骨转移、甲状腺癌和卡波西肉瘤。

结论

来自 CNS 肿瘤供者的器官移植导致疾病传播的风险非常低。因此,应积极提倡此类供者的器官捐赠,以扩大供者范围。

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