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40年来 (1979-2019) 发生的代移植损失原因的演变 (1979-2019)
Dolores Redondo-Pachón1, Emma Calatayud2, Anna Buxeda1
1Servicio de Nefrología, Hospital del Mar, Barcelona, Spain.
Nefrologia
|July 28, 2023
概括
移植移植的移植损失保持稳定,但原因正在转移. 近年来,血管血栓是早期移植失败的日益严重的原因,需要持续评估以改善结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 移植免疫学 移植免疫学
- 临床结果研究研究的临床结果.
背景情况:
- 40年来,移植接受者和移植的存活率有所下降,长期移植损失率保持稳定.
- 了解代移植损失的演变原因和风险因素对于改善患者的治疗结果至关重要.
- 这项研究分析了两个不同的移植期内移植损失和接受者死亡原因的变化.
研究的目的:
- 评估移植接受者的移植损失和死亡的原因.
- 为了比较两个时期的移植结果:1979-1999年和2000-2019年.
- 为了识别所有移植失效模式和受体/捐赠者配置文件的变化.
主要方法:
- 一个单一中心的队列研究包括从1979年5月到2019年12月接受脏移植的接受者.
- 移植损失被定义为受体死亡与功能植入物或植入物功能丧失.
- 用临床和组织学数据评估了移植损失的原因,比较了两个时间段.
主要成果:
- 在1522例移植中,722例 (47.5%) 发生了移植损失,主要是由于移植失败 (66.9%) 而不是死于功能移植 (33.1%).
- 心血管疾病,瘤和传染病是导致死亡的主要原因,在不同时期保持稳定.
- 异体移植的慢性功能障碍是移植失败的主要原因 (75%),抗体介导的排斥和间歇性纤维化/管管缩是常见的特定原因.
- 血管血栓形成是早期移植失败 (2000-2019年) 的主要原因,与早期 (1979-1999年) 的T细胞中介排斥形成鲜明对比.
结论:
- 移植患者的死亡主要与心血管和恶性疾病有关.
- 血管血栓症已成为当代移植中早期移植损失的重要原因.
- 对移植损失病因的持续评估对于提高移植成功率至关重要.
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