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在儿科中,移植前恶性瘤并不是移植衰竭的危险因素
Asher Mandel1, Samuel G Robinson1, Benjamin Peticca1
1Department of Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.
Pediatric transplantation
|February 6, 2024
概括
患有移植前恶性瘤 (PTM) 的儿科脏移植接受者与没有PTM的接受者相比,表现出相似的生存和移植结果. 儿童癌症史不会独立影响长期移植后的成功.
科学领域:
- 儿科脏病学 儿科脏病学
- 移植免疫学 移植免疫学
- 在瘤学瘤学.
背景情况:
- 在成年人中,移植前恶性瘤 (PTM) 与移植后的存活率较差有关,原因是免疫抑制.
- 关于PTM患者儿科脏移植结果的数据有限.
- 这项研究研究了儿科PTM患者的移植结果,包括各种癌症类型.
研究的目的:
- 为了比较儿科脏移植接受者之间的移植结果,有或没有移植前恶性病史 (PTM).
- 评估PTM对儿科移植接受者的移植存活率和整体患者存活率的独立影响.
主要方法:
- 利用美国器官共享网络数据库来识别患有PTM的儿科脏移植接受者.
- 根据关键变量 (移植年,接受者/捐赠者因素) 匹配PTM患者1:1与非PTM对照.
- 使用卡普兰-梅尔分析分析了死亡审查的移植和患者存活率,并报告了95%的置信区间.
主要成果:
- 分析了285名PTM和285名非PTM儿科患者的队列.
- 在PTM和非PTM组之间没有观察到死亡审查的移植失败率的显著差异 (HR 0.76;95% CI 0.54-1.1).
- 两组患者的整体存活率也相似 (HR 1.1;95% CI 0.66-2.0).
结论:
- 儿科恶性瘤病史对移植后的存活率有很小的独立影响.
- 与非PTM患者相比,患有PTM的儿科患者实现了相当的移植存活率.
- 患有先前恶性瘤的儿童的功能衰竭不应被视为移植的重大复杂因素.
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