活体捐献后的高血压和功能
Amit X Garg1,2,3,4,5,6, Jennifer B Arnold1, Meaghan S Cuerden1
1Lawson Health Research Institute and London Health Sciences, London, Ontario, Canada.
JAMA
|May 23, 2024
概括
活体捐献不会增加高血压或白尿的风险. 捐赠者经历了手术后较慢的EGFR下降,但长期可能具有较低的EGFR水平.
科学领域:
- 肝脏病学
- 移植
- 公共卫生
背景情况:
- 指导方针强调需要对活着的脏捐赠者的长期健康结果提供有力的证据.
- 评估捐赠后的风险对于捐赠者的安全和知情同意至关重要.
研究的目的:
- 为了比较活体脏捐赠者与非捐赠者的高血压发病率.
- 评估捐赠者与非捐赠者之间估计的球过率 (eGFR) 降低和白蛋白尿率的差异.
主要方法:
- 在2004年至2014年期间招募的924名活体脏捐赠者和396名非捐赠者的前性队列研究
- 用治疗权重的逆概率来平衡不同组的基线特征.
- 每年进行后续评估,直到2021年11月,监测血压,eGFR和白尿.
主要成果:
- 在权衡后,高血压发生率在捐赠者 (17%) 和非捐赠者 (17%) 之间是相似的 (HR,1.11,95% CI,0.75-1.66).
- 捐赠者平均EGFR下降速度较慢 (1.4毫升/分钟/1.73毫升/年),但更有可能在30-60毫升/分钟/1.73毫升之间 (47%对5%).
- 结核病发病率相似 (15%的捐赠者与11%的非捐赠者;HR,1. 46;95%的CI,0. 97-2.21)
结论:
- 与非捐赠者相比,活体脏捐赠并没有显著增加高血压或白尿的风险.
- 虽然捐赠者经过切除术后的EGFR下降速度较慢,但需要对降低的EGFR进行更密切的监测.
- 这项研究为活着的脏捐赠者提供了宝贵的长期健康结果数据.
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