针对患有末期脏病的肥胖患者的移植候选人的合作方法
Shauna Levy1, Abdallah Attia1, Mahmoud Omar2
1From the Divisions of Bariatric and Minimally Invasive Surgery (Levy, Attia, Galvani).
Journal of the American College of Surgeons
|March 12, 2024
概括
一个协作性的减肥和移植手术计划为末期脏疾病 (ESRD) 和肥胖患者提供了可行的脏移植途径. 这种综合方法改善了并发病症,并可能提高移植结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 腹部外科 腹部外科
- 移植手术 移植手术
背景情况:
- 升高的BMI是终末期病 (ESRD) 患者移植的重要障碍.
- 这一障碍不成比例地影响了少数民族和低收入人口,增加了透析成本.
- 代谢性减肥手术 (MBS) 在这个患者群体中未得到充分利用.
研究的目的:
- 评估一项合作计划的结果,该计划为ESRD患者提供代谢性减肥手术 (MBS) 在移植之前.
- 评估MBS对BMI,并发症和ESRD患者移植成功的影响.
主要方法:
- 在2019年1月至2023年6月期间,对183名ESRD患者进行了MBS转诊的回顾性研究.
- 36名患者接受了MBS (20名Roux-en-Y胃绕道,16名袖子胃切除术);10名接受了移植,15名在等待名单上.
- 分享资源 (营养师,社会工作者,数据库) 促进了团队合作.
主要成果:
- 平均BMI从转移时的46.4kg/m2下降到移植时的33.9kg/m2.
- 高血压药物的使用减少,血红蛋白A1C水平在MBS后显著改善.
- 所有10个MBS移植后的移植都运行良好,肌氨酸的中位数为1.5 mg/dL.
结论:
- 一个合作的MBS和移植手术计划为肥胖的ESRD患者提供了可行的移植途径.
- 这种方法有可能减少医疗保健差异,并改善移植后的结果.
- 接受MBS的ESRD患者需要意识到独特的潜在并发症.
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