成人肝脏再移植接受者的死亡率和发病率
Ali Dakroub1, Ahmad Anouti2, Thomas G Cotter2
1St. Francis Hospital and Heart Center, Roslyn, NY, USA.
Digestive diseases and sciences
|August 19, 2023
概括
肝移植 (LT) 后的再移植 (ReLT) 与5年死亡率和发病率的增加有关,主要是由于心血管问题和感染. 这些发现有助于在ReLT手术前评估患者并向他们提供咨询.
科学领域:
- 移植研究 移植研究
- 胃肠病学 胃肠病学
- 外科手术的结果
背景情况:
- 肝移植 (LT) 是对末期肝衰竭的关键治疗方法.
- 移植失败发生在高达20%的初级LTs中,需要再移植 (ReLT).
- 对于不可逆转的移植失败,ReLT是唯一的选择.
研究的目的:
- 为了研究肝脏再移植 (ReLT) 的术后结果.
- 为了比较首次LT和ReLT接受者之间的5年死亡率,发病率和住院时间.
主要方法:
- 从2003年至2016年使用移植受体科学注册表 (SRTR) 对肝移植受体的回顾性分析.
- 将患者分为第一LT和ReLT组进行分层.
- 主要结局包括5年死亡率,发病率和住院时间.
主要成果:
- 与首次LT接受者相比,ReLT接受者 (4%) 的5年死亡率 (OR 1.93),整体发病率 (OR 1.80) 和长时间住院 (OR 1.66) 显着更高.
- 在ReLT中较高的发病率包括心血管并发症,移植失败,感染和出血.
- 由于心血管疾病和感染,ReLT与5年死亡率的增加有关 (p < 0.001).
结论:
- ReLT与术后结果明显恶化有关,包括较高的5年死亡率和发病率.
- 心血管并发症和感染是RELT患者死亡率增加的关键驱动因素.
- 调查结果支持对ReLT候选人的手术前评估和预后咨询的改进.
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
01:24Tissue Transplantation
396
Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
396