肝移植患者中状年的预后价值:对移植后结果的影响
Hwa-Young Jang1, Sang-Bin Han, Jun-Hyeop Jeong
1Department of Anesthesiology and Pain Medicine, Laboratory for Cardiovascular Dynamics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Transplantation
|March 19, 2024
概括
肝移植 (LT) 候选人中中枢环结石化 (MAC) 与较高的短期心脏事件和较差的长期存活率有关,特别是在女性中. 早期识别和管理MAC对于改善LT结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 肝病学 肝病学是一种肝病学.
- 移植医学 移植医学
背景情况:
- 代谢性疾病和衰老增加了肝移植候选人的环化 (MAC) 的患病率.
- 心血管疾病是LT接受者死亡的主要原因,但MAC的影响仍未得到充分研究.
- 本研究研究了MAC的流行率,相关因素及其对LT结果的影响.
研究的目的:
- 调查肝移植候选人中状环状化 (MAC) 的流行情况.
- 在这个人群中确定与MAC相关的因素.
- 确定LT前MAC对主要心脏不良事件 (MACE) 和LT后长期存活率的影响.
主要方法:
- 分析了从2008年至2019年接受移植前心声扫描的4148名LT患者的队列.
- 多变量物流分析和沙普利增量解释 (SHAP) 评分被用来确定与MAC相关的重要因素.
- 主要结局是30天的MACE;次要结局是5年累积全因死亡率.
主要成果:
- 在3.0%的患者中,MAC存在,与年龄,酒精性肝病,慢性病,高尿血,高血压和冠状动脉疾病有关.
- 患有MAC的患者有显著更高的30天MACE率 (调整HR 1.67) 和较差的累积存活率 (调整HR 1.47).
- 与没有MAC的男性相比,患有MAC的女性的长期存活概率明显较差 (LT后10年).
结论:
- 在LT前的MAC与短期MACE的增加和长期生存率的降低有关.
- 患有MAC的女性代表了一组特别高的风险群体,在LT后出现不良结果.
- 识别和管理MAC及其风险因素对于提高LT后患者存活率至关重要.
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