移植接受者的脆弱性的重要性
Teresa Vázquez-Sánchez1, Verónica López1, Ruben Schuldt1
1Nephrology Department, Hospital Regional Universitario de Málaga and University of Málaga, IBIMA (Malaga Institute of Biomedical Research)-Plataforma BIONAND, RICORS2040 (RD21/0005/0012), Málaga, Spain.
Transplantation proceedings
|October 1, 2023
概括
脆弱性影响移植结果,增加了移植损失和死亡的风险. 然而,脏移植后的脆弱性可以显著改善,突出显示了康复的潜力.
科学领域:
- 科和移植手术 移植手术
- 老年医学和慢性疾病管理
- 炎症学和免疫学
背景情况:
- 脆弱性是一种慢性炎症综合征,在慢性病 (CKD) 患者中普遍存在.
- 移植前的脆弱性与移植 (KT) 后的不良结果有关,包括延迟的移植功能,再接收和减少的生存率.
- 了解脆弱的影响对于优化KT患者管理至关重要.
研究的目的:
- 评估脆弱性对移植 (KT) 接受者的结局的影响.
- 评估在等待KT的患者中虚弱的患病率.
- 为了确定K.T.后的脆弱状态是否发生变化.
主要方法:
- 一项纵向前性研究包括65名移植等待名单 (WL) 的患者.
- 使用FRAIL尺度评估脆弱性;临床数据,依赖性和生活质量 (KDQOL-36) 在WL纳入和在KT后3个月和12个月收集.
- 统计分析比较了脆弱和强壮患者之间的结果.
主要成果:
- 超过60%的WL患者被确定为虚弱 (FRAIL评分≥1).
- 脆弱的患者表现出更高的并发症负担 (查尔森指数),更低的功能状态 (巴特尔指数) 和更差的生活质量.
- 虽然在统计学上不显著,但脆弱的患者显示出较低的移植和患者存活率的趋势. 重要的是,在KT后12个月内,67%的患者的脆弱性得到改善.
结论:
- 在移植候选人中,脆弱性很常见,与更差的生活质量,依赖程度增加以及更高的死亡率/移植损失风险有关.
- 很大一部分患者经历移植后的脆弱性改善.
- 针对KT前或后脆弱性的干预措施可能会改善长期结果.
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