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通过评估脑死亡后未分配的器官来扩大胰腺供体库:研究方案临床试验(符合SPIRIT标准)

Expanding pancreas donor pool by evaluation of unallocated organs after brain death: Study protocol clinical trial (SPIRIT Compliant).

作者信息

Kulu Yakup, Khajeh Elias, Ghamarnejad Omid, Nikdad Mohammadsadegh, Sabagh Mohammadsadegh, Ali-Hasan-Al-Saegh Sadeq, Nadalin Silvio, Quante Markus, Pisarski Przemyslaw, Jänigen Bernd, Reißfelder Christoph, Mieth Markus, Morath Christian, Goeppert Benjamin, Schirmacher Peter, Strobel Oliver, Hackert Thilo, Zeier Martin, Springel Rainer, Schleicher Christina, Büchler Markus W, Mehrabi Arianeb

机构信息

Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg.

Department of General, Visceral, and Transplant Surgery, University Hospital Tuebingen, Tuebingen.

出版信息

Medicine (Baltimore). 2020 Mar;99(10):e19335. doi: 10.1097/MD.0000000000019335.

Abstract

BACKGROUND

Pancreas graft quality directly affects morbidity and mortality rates after pancreas transplantation (PTx). The criteria for pancreas graft allocation are restricted, which has decreased the number of available organs. Suitable pancreatic allografts are selected based on donor demographics, medical history, and the transplant surgeon's assessment of organ quality during procurement. Quality is assessed based on macroscopic appearance, which is biased by individual experience and personal skills. Therefore, we aim to assess the histopathological quality of unallocated pancreas organs to determine how many unallocated organs are potentially of suitable quality for PTx.

METHODS AND ANALYSIS

This is a multicenter cross-sectional explorative study. The demographic data and medical history of donor and cause of rejection of the allocation of graft will be recorded. Organs of included donors will be explanted and macroscopic features such as weight, color, size, and stiffness will be recorded by 2 independent transplant surgeons. A tissue sample of the organ will be fixed for further microscopic assessments. Histopathologic assessments will be performed as soon as a biopsy can be obtained. We will evaluate up to 100 pancreata in this study.

RESULT

This study will evaluate the histopathological quality of unallocated pancreas organs from brain-dead donors to determine how many of these unallocated organs were potentially suitable for transplantation based on a histopathologic evaluation of organ quality.

CONCLUSION

The comprehensive findings of this study could help to increase the pancreas graft pool, overcome organ shortage, reduce the waiting time, and also increase the number of PTx in the future. Registration number: ClinicalTrials.gov: NCT04127266.

摘要

背景

胰腺移植(PTx)后,胰腺移植物质量直接影响发病率和死亡率。胰腺移植物分配标准受限,导致可用器官数量减少。合适的胰腺同种异体移植物是根据供体人口统计学、病史以及移植外科医生在获取过程中对器官质量的评估来选择的。质量是根据宏观外观评估的,这受个人经验和技能的影响。因此,我们旨在评估未分配的胰腺器官的组织病理学质量,以确定有多少未分配的器官可能具有适合PTx的质量。

方法与分析

这是一项多中心横断面探索性研究。将记录供体的人口统计学数据、病史以及移植物分配的排斥原因。纳入供体的器官将被切除,两名独立的移植外科医生将记录其重量、颜色、大小和硬度等宏观特征。器官的组织样本将被固定以进行进一步的显微镜评估。一旦获得活检样本,将立即进行组织病理学评估。本研究将评估多达100个胰腺。

结果

本研究将评估脑死亡供体未分配的胰腺器官的组织病理学质量,以根据器官质量的组织病理学评估确定这些未分配的器官中有多少可能适合移植。

结论

本研究的综合结果有助于增加胰腺移植物库,克服器官短缺,减少等待时间,并在未来增加PTx的数量。注册号:ClinicalTrials.gov:NCT04127266。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8112/7478640/02bd57dc3946/medi-99-e19335-g001.jpg

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