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活着的脏捐赠者的瘦体质对术后功能有影响
Robert A Keenan1,2, Aisling U Nic An Riogh3,4, David Brennan5
1Department of Surgical Affairs, Royal College of Surgeons, Dublin, Ireland. Robertanthonykeenan@rcsi.ie.
World journal of urology
|April 6, 2024
概括
活着的脏捐赠者具有较低的骨肌肉质量,这种情况被称为肉症,在捐赠一年后显示出更好的功能. 麻症不应该阻止个人成为活体脏捐赠者.
科学领域:
- 科和移植手术 移植手术
- 医学成像和身体组成分析分析.
背景情况:
- 活体捐赠者的移植是慢性病的首选治疗方法.
- 捐赠者选择标准的目的是尽量减少风险,同时最大限度地提高移植的存活率.
- 捐赠者的身体组成,特别是瘦骨肌肉质量,对脏切除术后功能的影响需要进一步调查.
研究的目的:
- 评估活体脏捐赠者的瘦骨肌肉质量与脏切除术后一年的功能之间的关联.
- 评估捐赠者因素 (如BMI,高血压和年龄) 对术后功能的影响.
主要方法:
- 计算机断层扫描血管造影 (CT血管造影) 用于供体工作.
- 在L3脊椎的骨肌面积使用专用软件量化,以导出骨肌指数 (SMI).
- 石症被定义为SMI低于预定义的值.
- 分析了CT衍生的SMI,捐赠者人口统计 (性别,年龄,BMI),高血压和术后淋巴细胞过率 (GFR) 在12个月之间的相关性.
主要成果:
- 总共有275名活体捐赠者被纳入该研究.
- 29%的捐赠者根据CT衍生的测量结果被确定为sarcopenic.
- 在捐赠后的一年,与非肉体捐赠者相比,肉体捐赠者表现出明显更高的GFR (69.3比63.9毫升/分钟/1.73米2,p < 0.001).
- 移植后1年,更年轻的捐赠者年龄和肉类的存在与更好的功能有关.
结论:
- 活体脏捐赠者的低瘦骨肌肉质量 (sarcopenia) 与脏切除术后一年的功能恢复不相关.
- 麻症不应被认为是活体脏捐献的禁忌.
- 供体年龄和体质构成是供体评估中需要考虑的重要因素,以获得最佳的长期结果.
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