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预测晚期急性正管心脏移植拒绝的预测因素

G L Winters¹, M R Costanzo-Nordin, E J O'Sullivan

¹Department of Pathology, Loyola University Medical Center, Maywood, IL 60153.

|November 1, 1989

概括

经历多次早期排斥事件的正确心脏移植接受者面临着晚期急性排斥的更高风险. 感染似乎也与后来的排斥事件有关,这需要进一步调查.

科学领域:

心脏病学心脏病学
免疫学免疫学免疫学
移植医学移植医学

背景情况:

晚期急性排斥在正管心脏移植 (OHT) 后是一个重大问题.
识别晚期排斥的预测因素对于改善长期患者的治疗结果至关重要.

研究的目的:

为了确定晚期急性排斥的预测因素 (发生在OHT后1年以上).
调查早期排斥发作,感染和晚期急性排斥之间的关系.

主要方法:

对53名心脏移植接受者进行了回顾性分析,这些接受者在移植后至少存活了一年.
随访持续时间从402天到1,151天 (平均841天).
晚期排斥 (LR) 和非排斥 (NR) 组之间的排斥事件,感染率和临床因素的比较.

主要成果:

在第一年内有两次或两次以上中度/重度排斥发作的患者明显更有可能经历晚期急性排斥 (86%对36%,p<0.001).
晚期排斥患者在移植后感染的次数显著增加 (2.0对0.9,p<0.05).
大约40%的晚期急性排斥发作发生在感染后一个月内.

结论:

多次早期排斥发作是OHT后晚期急性排斥的关键预测因素.
感染可能在引发晚期急性排斥发作中发挥作用,需要进一步研究.
患有早期排斥病史的患者可能受益于更密切的长期监测和潜在的强化免疫抑制.

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