在移植人群中保守的管理
Naoka Murakami1, Amanda J Reich2, Martha Pavlakis3
1Harvard Medical School, Boston, MA; Division of Renal Medicine, Brigham and Women's Hospital, Boston, MA.
Seminars in nephrology
|July 27, 2023
概括
保守性管理 (CKM) 为晚期慢性病患者提供透析的替代方案,包括移植接受者接近全移植失败. 这种方法侧重于控制症状并延迟疾病的进展.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植医学 移植医学
- 抚慰性护理是一种缓解性护理.
背景情况:
- 保守性管理 (CKM) 是一种已被接受的治疗选择,用于晚期慢性病.
- 慢性结核病包括没有透析的积极医疗管理,旨在延迟疾病的进展并最大限度地减少症状.
- 这是一个适合移植接受者,移植衰退和高风险的合适选择.
研究的目的:
- 审查用于管理移植接受者失败的全移植的临床考虑因素.
- 讨论将CKM纳入这一患者群体的选择.
- 探索CKM提供的财务和政策方面.
主要方法:
- 在晚期慢性病中对保守管理的文献综述.
- 对置换疗法临床决策过程的分析.
- 讨论患者的护理协调和团队支持.
主要成果:
- 对于移植受体而言,CKM是一种可行的选择,尤其是那些低EGFR (<20毫升/分钟/1.73毫米) 的患者.
- CKM解决了与全移植失败相关的高发病率和死亡率风险,有或没有透析.
- 专业间的支持对于正在经历护理过渡的患者至关重要.
结论:
- 应为移植接受者提供CKM作为一种选择,他们面临着异种移植失败.
- 需要进行进一步的研究,以优化CKM与现有护理结构的整合.
- 多学科团队对于支持患者在护理过渡过程中至关重要.
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