接受免疫抑制药物治疗的移植失败患者感染的危险因素
Lauren Ogawa1, Omer E Beaird1, Joanna M Schaenman1
1Division of Infectious Diseases, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, CA, United States.
Frontiers in nephrology
|September 7, 2023
概括
免疫抑制 (IS) 移植失败的患者面临感染风险,透析并发症构成重大威胁. 像AV管放置这样的策略可能会降低感染风险,但需要更多的研究.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 移植免疫学 移植免疫学
- 传染性疾病 传染性疾病
背景情况:
- 患有移植失败的患者经常继续免疫抑制 (IS) 以保持功能并防止排斥.
- 从历史上看,IS与感染,住院和死亡风险的增加有关.
- 随着IS管理的不断发展,需要对脏全移植失败的特定治疗方案相关的感染风险进行审查.
研究的目的:
- 审查关于失败的合移植管理和相关感染风险的文献.
- 讨论目前在这种患者群体中预防感染的做法.
- 确定有关IS和移植失败的感染的知识差距.
主要方法:
- 1995年至2022年间发表的15项研究的文献综述.
- 研究的重点是失败的全移植和感染经历的患者.
- 分析包括感染类型和减少IS的定义.
主要成果:
- 感染被广泛记录下来,包括Candida,Mycobacterium结核病和Aspergillus在指定时.
- 减少IS的定义各不相同,从降低剂量到单一治疗.
- 尽管IS减少,但患者仍然面临机会性和非机会性感染的风险.
- 透析并发症,而不是IS,成为潜在的更大的感染风险.
结论:
- 失败的移植患者在IS上面临着严重的感染风险,透析并发症是主要问题.
- 积极的策略,如优先考虑动脉静脉 (AV) 管而不是血液透析导管,可以减轻感染风险.
- 进一步的研究至关重要,以澄清感染类型,时间和最佳的IS逐渐减少策略,以改善监测和预防.
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