在左心室辅助器件支持下功能对心脏功能和心脏移植后临床事件的影响
Nobutaka Kakuda1, Eisuke Amiya1,2, Masaru Hatano1,3
1Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Clinical transplantation
|August 24, 2023
概括
在患有左心室辅助器件 (LVAD) 的患者中,移植前脏功能障碍影响心脏移植 (HTx) 后的长期存活率,尽管心脏功能保持. 这突显了脏健康在心脏移植结果中的重要性.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植医学 移植医学
背景情况:
- 左心室辅助装置 (LVAD) 的支持对于等待心脏移植 (HTx) 的末期心力衰竭患者至关重要.
- 以前存在的功能障碍可能会使移植后的结果复杂化.
- 功能障碍对心脏功能的影响和LVAD支持的HTx后的预后需要进一步调查.
研究的目的:
- 研究LVAD患者移植前功能障碍对心脏移植后心脏功能的影响.
- 评估移植前功能障碍对心脏移植后患者预后的影响.
主要方法:
- 对132名接受LVAD植入,随后接受HTx (2007-2022) 的患者进行了回顾性分析.
- 患者分为功能障碍 (RD;eGFR<60mL/min/1.73m2) 和非功能障碍 (NRD) 的两组.
- 移植后心脏功能,血液动力学,移植排斥和群体之间的存活率的比较.
主要成果:
- 与NRD组 (n=84) 相比,RD组 (n=48) 年龄较大,与NRD组 (n=84) 相比,对右心室衰竭史有更多的趋势.
- 在HTx后的RD和NRD组之间没有观察到长期心声学或血液动力学参数的显著差异.
- 移植排斥率相似,但RD组的死亡率显著增加,HTx后需要更多的维持透析.
结论:
- 在LVAD患者的移植前功能障碍对心脏移植后的长期存活有不利影响.
- 功能障碍影响临床过程和死亡率,尽管在HTx后保留了移植心脏功能.
- 在移植前患有功能障碍的患者中,维护透析的启动更为频繁.
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