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老年捐赠者的老年接受者的结果:倾向性评分分析
Elena Cuadrado-Payán1,2, Enrique Montagud-Marrahi1,2, Joaquim Casals-Urquiza1
1Department of Nephrology and Kidney Transplantation, Hospital Clinic Barcelona, Barcelona, Spain.
Frontiers in nephrology
|September 7, 2023
概括
较老的移植接受者 (≥75岁) 与较年轻的患者 (60-65岁) 相比,显示出类似的移植和接受者存活率. 高龄不是移植的绝对禁忌,支持更广泛的资格.
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:
- 转诊移植的患者年龄越来越大.
- 关于晚年对移植结果的影响的争议.
研究的目的:
- 评估75岁及以上的脏移植接受者的移植和接受者存活率.
- 为了比较老年 (≥75岁) 和年轻 (60-65岁) 移植接受者之间的结果.
主要方法:
- 追溯性研究比较了两个队列:75岁以上的接受者和60-65岁的接受者.
- 倾向性评分分析,包括治疗权重反向概率 (IPTW) 考克斯回归.
- 评估受体存活率和死亡审查的移植存活率.
主要成果:
- 在年龄较大 (91%,74%) 和年轻 (95%,82%) 组之间,未调整的1年和5年接受者生存率没有显著差异 (P=0.06).
- IPTW加权分析显示,接受者年龄≥75与死亡风险增加无关 (HR1.88;P=0.14).
- 两组之间未经调整的1年和5年死亡审查的移植存活率没有显著差异 (老年人:96%,83%,年轻人:99%,89%,P=0.08).
- 在IPTW加权分析中发现,75岁以上的年龄与移植损失风险增加之间没有关联 (HR 1.95;P=0.23).
结论:
- 75岁或以上的接受者年龄似乎不是移植结果较差的独立风险因素.
- 高龄不应该是移植的绝对禁忌.
- 这些发现支持将移植的资格标准扩大到包括老年人.
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