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经济学人:心脏移植新方法或可增加供体心脏
Researchers say a new method for heart transplants could increase the number of available organs and save more lives.Currently, most transplanted hearts come from donors who have been declared brain dead.This means the person no longer has signs of brain function after suffering a serious injury.In a brain death, machines can keep the body breathing and can provide oxygen to organs until they can be recovered and put on ice.But the new method would take hearts from medical cases known as circulatory deaths.These cases are also known as donation after circulatory death, or DCD.Circulatory deaths happen when a person has a nonsurvivable brain injury, but still has some brain function.In these cases, family members can decide to withdraw all life support measures.This means organs go without oxygen for a time before they can be recovered.
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研究人员表示,一种新的心脏移植方法可以增加可用器官的数量,拯救更多的生命。目前,大多数移植的心脏来自已被宣布脑死亡的捐赠者。意思是这个人在遭受严重伤害后大脑不再有功能。在脑死亡时,机器可以保持身体呼吸,并为器官提供氧气,直到它们恢复并冷藏。但新方法将从被称为循环性死亡的医学病例中摘取心脏。这些病例也被称为循环性死亡后捐献。当一个人有无法存活的脑损伤,但仍有一些脑功能时,就会发生循环性死亡。在这种情况下,家人可以决定撤销所有生命维持措施。这意味着器官在恢复之前会有一段时间缺氧。
Currently, kidneys and some other organs are taken from people suffering circulatory deaths.But doctors have resisted using hearts because of possible organ damage from a lack of oxygen.A new study suggests that hearts might also be recoverable from cases of circulatory deaths.Researchers at North Carolina's Duke University School of Medicine led the study, which was recently published in the New England Journal of Medicine.The researchers said using hearts from circulatory deaths could possibly give thousands more patients a chance at a lifesaving transplant.And it could increase the number of donor hearts by 30 percent."Honestly if we could snap our fingers and just get people to use this, I think it probably would go up even more than that," transplant doctor Jacob Schroder told The Associated Press."This really should be standard of care," he said.With the new method, doctors can remove hearts in circulatory deaths and put them in a machine that "reanimates" them.This process pumps blood and nutrients through the heart as they are being transported.The organs can also be tested to make sure they are effectively functioning before they are transplanted.
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目前,肾脏和其他一些器官是可以从循环性死亡的人身上摘取的。但医生曾拒绝使用心脏,因为缺氧可能会对器官造成损害。一项新的研究表明,心脏也可能会从循环性死亡的病例中恢复过来。北卡罗来纳州杜克大学医学院的研究人员领导了这项研究,该研究最近发表在《新英格兰医学杂志》上。研究人员表示,使用来自循环性死亡病例的心脏可能会给数千名患者带来挽救生命的移植机会。这可能会使捐赠的心脏数量增加30%。移植医生雅各布·施罗德告诉美联社:“老实说,如果我们打个响指就能让人们使用它,我想它可能会增加得更多。”他说:“这真的应该成为护理的标准”。通过这种新方法,医生可以摘除循环性死亡病例的心脏,并将其放入机器中,使其“恢复活力”。在它们被运输的过程中,会有血液和营养物质输送到心脏。在移植之前,还可以对器官进行测试,以确保它们能有效地发挥作用。
The study involved multiple hospitals around the country, as well as 180 transplant patients.Half the patients received DCD hearts and half were given hearts from brain-dead donors that were transported on ice.Survival rates six months later were about the same – 94 percent for recipients of cardiac-death donations and 90 percent for those who got the usual hearts, the researchers reported.The findings are exciting and show the possibility "to increase fairness and equity in heart transplantation…" said Dr. Nancy Sweitzer.She is a heart transplant specialist at Washington University in St. Louis.Sweitzer, who was not part of the study, said she thinks the new method will permit more people with heart failure to receive lifesaving treatment.In the U.S. last year, 4,111 heart transplants were performed.While this was a record number, it is not nearly enough to meet the need.Hundreds of thousands of people suffer from advanced heart failure but many are never offered a transplant.Still others die waiting for one.I'm Bryan Lynn.
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这项研究涉及全国多家医院以及180名移植患者。一半的患者接受了循环性死亡后捐献者的心脏,一半的患者接受了冷冻运输过来的脑死亡捐赠者的心脏。研究人员报告称,六个月后的存活率大致相同——接受心脏死亡捐赠者心脏的患者的存活率为94%,接受正常心脏捐赠者心脏的患者的存活率为90%。南希·斯威策博士说,这一发现令人振奋,表明有可能会“增加心脏移植的公平性”。她是华盛顿大学-圣路易斯的心脏移植专家。斯威策没有参与这项研究,她说,她认为新方法将允许更多的心力衰竭患者接受挽救生命的治疗。去年,美国共进行了4111例心脏移植手术。虽然这是一个创纪录的数字,但远远不足以满足需求。数十万人患有晚期心力衰竭,但许多人从未接受过移植手术。还有一些人在等待合适心脏的过程中死亡。布莱恩·林恩为您播报。
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