获得第一次和重复移植的年龄差异
Yusi Chen1, Bryce Churilla2, JiYoon B Ahn3
1Department of Surgery, New York University Grossman School of Medicine and New York University Langone Health, New York, NY.
Transplantation
|August 1, 2023
概括
老年人在获得移植 (KT) 方面面临着显著的差异,无论是初始手术还是重复手术. 虽然随着时间的推移,列出首次KT的差异有所减少,但老年患者的获取仍然是一个问题.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植医学 移植医学
- 老年医学 老年医学
背景情况:
- 与年轻人相比,老年患者在移植 (KT) 等候名单上的频率较低.
- 在获得首次KT和重复KT (re-KT) 时,年龄差异的程度和趋势尚不清楚.
研究的目的:
- 调查世俗趋势和年龄差异在获得第一KT和re-KT的程度.
- 为了比较年长 (≥65岁) 和年轻 (18-64岁) 成年透析患者之间列出和接受首次KT与重复KT的可能性.
主要方法:
- 利用美国脏数据系统 (1995-2018) 分析了2,496,743名移植先透析患者和110,338名移植失败的成年接受者.
- 采用了考克斯的比例危险模型来评估在列出和接受首次KT和重复KT时的年龄差异.
主要成果:
- 与年轻患者相比,老年患者被列入并接受首次KT (分别为aHR=0.18,aHR=0.88) 和重复KT (分别为aHR=0.40,aHR=0.76) 的可能性较低.
- 第一次KT的年龄差异大于重复KT的年龄差异,并且在1995-2018年间,这种差异显著减少.
- 重复KT上市的年龄差异保持不变,而第一次和重复KT的年龄差异在年龄组之间没有显著差异.
结论:
- 在获得首次KT和重复KT方面,年龄差异仍然很大.
- 这些差异在患有移植失败的老年人中有所减少.
- 需要进一步的研究来了解候选障碍,并随着候选人比例的增加,确定合适的老年候选人.
相关概念视频
01:28Kidney Transplant I: Introduction
29
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
29
01:26Kidney Transplant II: Surgical Procedure
36
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
36
01:16Kidney Transplant III: Nursing Management
39
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
39
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
35
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
35
01:17Factors Affecting Renal Clearance: Renal Impairment
119
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
119
01:25Chronic Kidney Disease I: Introduction
36
Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage kidney disease (ESKD). At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate...
36