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在现代时代对小儿科患者进行肠移植的评估
Nathan S Bryan1, Shannon C Russell2, Oguz Ozler1
1Department of Pediatrics, MedStar Georgetown University Hospital, Washington, District of Columbia, USA.
Journal of pediatric gastroenterology and nutrition
|June 3, 2024
概括
评估用于肠移植 (ITx) 的小儿肠衰竭 (IF) 患者经常患有IF相关的肝病 (IFALD). 并发症影响生存,较高的肌素与更好的结果相关,ITx与更差的生存相关.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 肝病学 肝病学是一种肝病学.
- 移植手术 移植手术
背景情况:
- 肠衰竭 (IF) 在儿科患者中带来了重大挑战.
- 与肠道衰竭相关的肝病 (IFALD) 是考虑肠道移植 (ITx) 的首要驱动因素.
- 管理IF需要全面的策略,包括肠道康复.
研究的目的:
- 审查最近对ITx的IF儿科患者的评估.
- 分析ITx上列和未列患者的等待名单决策和结果.
- 为了确定影响儿童IF患者生存的因素,进行ITx评估.
主要方法:
- 对97名被评估为ITx的儿科患者 (2014-2021) 的回顾性图表审查.
- 包括参考机构的数据,实验室检测,成像和肝脏活检.
- 使用Kaplan-Meier估计和Cox比例危险回归的生存分析.
主要成果:
- 大多数提交来自外部机构,IFALD占案件的三分之一.
- 67%的患者被列入等待名单,40%的IFALD.
- 较高的血清肌素与较高的评估后存活率相关,而ITx和较高的纤维素原与较低的存活率相关.
结论:
- 尽管在FI管理方面取得了进展,但IFALD仍然是儿科ITx转诊的重要指示.
- 与IF候选症相关的并发症影响了后评估和后ITx生存.
- 仔细的患者选择和管理对于优化儿科IF患者的治疗结果至关重要.
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