在急性水出血后转移肝脏移植:多中心队列研究
Sofia Bragança1, Marta Ramos2, Sara Lopes3
1Gastroenterology Division, Fernando Fonseca Hospital, Amadora.
European journal of gastroenterology & hepatology
|March 13, 2024
概括
在急性水出血 (AVB) 后,肝移植 (LT) 的转诊率很低. 在患有AVB的肝硬化患者中早期LT评估显著降低了长期死亡率.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植医学 移植医学
- 胃肠病学 胃肠病学
背景情况:
- 急性水出血 (AVB) 是肝硬化的一种严重并发症.
- 在AVB之后,肝移植 (LT) 的转诊模式不一致.
- 在AVB之后,LT转诊对患者结果的影响需要进一步描述.
研究的目的:
- 在患有AVB的肝硬化患者中描述LT转诊实践.
- 评估LT转诊与临床结果之间的关联,特别是所有原因死亡率.
主要方法:
- 来自里斯本三家医院的143名肝硬化患者的逆向观察队列研究 (2018-2019).
- 主要暴露:转诊为LT. 主要终点:在住院两年内因任何原因死亡.
- 为了进行统计分析,进行了混调整.
主要成果:
- 只有21.0%的患者被评估为LT,9.1%被评估在入院前,11.9%在两年内.
- 肝移植仅在2.1%的患者中进行.
- 在调整了混因素后,对LT的转诊与两年全因死亡率的显著降低有关 (aHR:0.20;95%CI:0.05-0.85).
结论:
- 在这个多中心队列中,只有不到四分之一的AVB肝硬化患者接受了正式的LT评估.
- 在AVB之后,改善和及时转诊以进行LT评估可能会提高这些高风险患者的长期生存率.
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