移植后二次性甲状腺功能障碍症的解决和对移植存活的影响
Rongzhi Wang1, Griffin Price2, Mitchell Disharoon2
1Department of Surgery, University of Alabama at Birmingham, Birmingham, AL.
Annals of surgery
|June 16, 2023
概括
移植 (KT) 后持续性偏甲状腺症 (HPT) 是常见的,影响75%的患者. 这种情况显著增加了全移植失败的风险,强调了需要紧密的甲状腺前激素 (PTH) 监测后KT.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
- 移植免疫学 移植免疫学
背景情况:
- 偏甲状腺症 (HPT) 在末期病患者中很普遍.
- 移植 (KT) 可以解决HPT,但副甲状腺激素 (PTH) 水平在移植后往往没有得到充分监测.
- 了解后KT持续的HPT对于移植的存活至关重要.
研究的目的:
- 为了确定KT后持久性HPT的患病率.
- 为了研究持续HPT对代移植存活率的影响.
- 为了确定与持续的HPT后KT.相关的因素.
主要方法:
- 从2015年1月到2021年8月,对1554名KT受益人的回顾性分析.
- 将患者分类为已解决的HPT与持续的HPT后的KT组.
- 倾向性得分匹配和多变量回归来分析全移植失败风险.
主要成果:
- 只有25.1%的患者在KT后实现了HPT解决.
- 持久的HPT与KT时更高的PTH水平有关,并且增加了KT前的cinacalcet使用.
- 持续的HPT,无论是正常血还是高血,都显著增加了全移植失败的风险 (HR 2.5-2.6).
结论:
- 持久性HPT是KT后的常见并发症,在75%的患者中发生.
- 持续的HPT是造成代移植失败的重要危险因素.
- 紧密监测后KT的PTH水平对于及时干预和改善结果至关重要.
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