在预防性脏移植后持续性副甲状腺功能障碍
Manabu Okada1, Tetsuhiko Sato2, Yuki Hasegawa3
1Department of Transplant Surgery and Transplant Nephrology, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya, Aichi, 4668650, Japan. ubanamadako@yahoo.co.jp.
Clinical and experimental nephrology
|June 23, 2023
概括
移植前的副甲状腺激素 (PTH) 水平和捐赠脏功能预测了预防性脏移植 (PKT) 后的副甲状腺症 (HPT). HPT与较差的移植存活率有关,这突显了需要仔细监测PKT后的需要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
- 移植免疫学 移植免疫学
背景情况:
- 长期透析是已知的持续性副甲状腺功能障碍症 (HPT) 的预测因素,在移植后 (KTx).
- 预防性移植 (PKT) 的日益增长趋势需要了解HPT发生率,预测因素和这一特定人群的结果.
- 目前关于PKT后HPT的知识仍然有限.
研究的目的:
- 在PKT后一年确定HPT的预测因子.
- 评估HPT在PKT后对移植存活的临床影响.
- 阐明移植前因素与PKT后HPT之间的关系.
主要方法:
- 在2000年至2016年期间接受PKT的340名患者进行了回顾性队列研究.
- 移植后一年内移植损失的患者排除.
- 基于完整的副甲状腺激素 (PTH) 水平 (>80 pg/mL) 或不明原因的高血症的HPT定义;分析移植存活率作为次要结果.
主要成果:
- 移植前的PTH水平 (OR,5.480) 和捐赠者估计的膜过率 (OR,0.978) 是PKT后HPT的独立预测因素.
- 在PKT治疗一年后,152名患者出现HPT,而188名患者仍然没有HPT.
- 死亡审查的移植存活率在HPT组 (90.4%) 与10年后无HPT组 (96.4%) 相比显著较低 (P=0.009).
结论:
- 移植前PTH水平升高和捐赠功能下降是PKT后HPT的显著预测因素.
- 在PKT之后的HPT与移植存活结果的降低有关.
- 这些发现强调了在接受PKT的患者中评估移植前PTH和捐赠功能的重要性.
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