血栓性肝病变的临床过程心脏移植前/后心脏移植
Lorenz Balcar1,2, Georg Semmler1,2, Bernhard Scheiner1,2
1Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Wiener klinische Wochenschrift
|June 28, 2023
概括
充血性肝病症是心力衰竭的并发症,在心脏移植后通常是可逆的. 肝功能评分和炎的严重程度可以预测移植后的结果.
科学领域:
- 心脏病学 心脏病学
- 肝病学 肝病学是一种肝病学.
- 移植医学 移植医学
背景情况:
- 心力衰竭 (HF) 可以导致肝血管压力升高,导致肝脏血流失和充血性肝病变.
- 充血性肝病是已知的并发症,患有晚期心力衰竭的患者.
研究的目的:
- 在接受心脏移植 (HTX) 的患者中确定充血性肝病变的患病率.
- 评估患有充血性肝病症的患者的移植后过程和结果.
主要方法:
- 分析了2015-2020年间接受HTX的205名患者的队列.
- 充血性肝病是由成像和肝损伤证据上的肝脏拥堵来定义的.
- 评估了实验室参数,炎严重程度和临床事件,以及HTX后的结果.
主要成果:
- 在上市时,29%的患者患有充血性肝病,其特点是,血清含量降低,胆酶活性降低,肝损伤标志物更高.
- 患有充血性肝病症的患者有较高的白蛋白-白素 (ALBI) 和末期肝病 (MELD) 模型得分.
- 在HTX后,中位数的实验室参数和得分正常化,86%的炎患者经历了解决. 总体生存率为87%,罕见的肝脏相关事件为87%.
- 严重的炎,低胆酶和MELD/MELD-XI评分预测了HTX后一年内炎的持续性或死亡.
- 年龄,男性性别和严重风是死亡率的独立预测因素. 在HTX后4周的ALBI和MELD得分强烈表明生存率.
结论:
- 充血性肝病症和相关的炎在心脏移植后在很大程度上是可逆的.
- 与肝脏相关的得分和炎的严重程度对于心脏移植后期的预后非常有价值.
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