Zamora-Valdés Daniel, Leal-Leyte Pilar, Díaz-Muñoz Inés, Méndez-Sánchez Nahum
Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico.
Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico.
Transplant Proc. 2020 May;52(4):1062-1065. doi: 10.1016/j.transproceed.2020.02.009. Epub 2020 Mar 13.
Evaluation of donation and transplantation activity allows for strategic planning. Liver donation and transplantation activity in the Metropolitan Area of the Valley of Mexico (MAVM) has never been published. The aim of this study was to analyze deceased liver donation and transplantation, liver use, and observed-to-expected (O:E) ratio in the MAVM.
Information from 2014 to 2018 was obtained from the National Center of Transplantation and adjusted per million persons. O:E ratio was analyzed and compared between regions.
From all Mexican states, Mexico City (CDMX) had the highest liver donation and transplantation per million persons rates in the country. In contrast, when the MAVM was considered, the region was sixth in liver donation and first in transplantation, although the latter was not statistically different to Nuevo Leon (5.4 vs 4.3; P = .52). Liver use in Mexico State within the MAVM (37.8%) was not different from that of CDMX (15th in the nation, 35.2%, P = .78), while deceased donor liver use in the rest of the state was statistically higher (52.4%, P = .01; third in the nation). O:E ratio was higher in Mexico states outside the MAVM (CDMX 10.1, 2.1 vs 29.4, 26.5; P = .009).
Analysis of deceased donation and transplantation of Mexican states without considering the metropolitan areas is insufficient. To consider CDMX as a region without acknowledging the MAVM leads to an inappropriately small denominator during efficiency analysis.
对捐赠和移植活动进行评估有助于进行战略规划。墨西哥谷大都市区(MAVM)的肝脏捐赠和移植活动从未有过相关报道。本研究旨在分析MAVM地区的尸体肝脏捐赠与移植情况、肝脏使用情况以及观察到的与预期的(O:E)比率。
从国家移植中心获取2014年至2018年的信息,并按每百万人进行调整。对各地区之间的O:E比率进行分析和比较。
在墨西哥所有州中,墨西哥城(CDMX)的每百万人肝脏捐赠和移植率在全国最高。相比之下,若将MAVM视为一个地区,该地区在肝脏捐赠方面排名第六,在移植方面排名第一,尽管后者与新莱昂州在统计学上无差异(5.4对4.3;P = 0.52)。MAVM内墨西哥州的肝脏使用率(37.8%)与CDMX的肝脏使用率(在全国排名第15,为35.2%,P = 0.78)无差异,而该州其他地区的尸体供肝使用率在统计学上更高(52.4%,P = 0.01;在全国排名第三)。MAVM以外的墨西哥州的O:E比率更高(CDMX为10.1,2.1对29.4,26.5;P = 0.009)。
不考虑大都市区对墨西哥各州的尸体捐赠和移植情况进行分析是不充分的。在效率分析中,将CDMX视为一个地区而不承认MAVM会导致分母过小。