再移植后的长期移植和患者存活率
Dana Bielopolski1,2, Aviad Gravetz3,4, Timna Agur5,4
1Nephrology and Hypertension Institute, Rabin Medical Center, Petach Tikva, Israel.
Annals of transplantation
|June 21, 2024
概括
多个脏移植的存活率与单个移植的存活率相似. 重复移植的接受者经历较低的死亡审查的移植失败风险,特别是那些有活体供体的接受者,支持对年轻患者的考虑.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 移植手术 移植手术
- 免疫学 免疫学 免疫学
背景情况:
- 接受脏移植的人通常有更长的预期寿命,因此需要考虑随后的移植.
- 器官分配中的伦理考虑在需要进行多次脏移植时出现.
- 评估多重移植的长期安全性和结果至关重要.
研究的目的:
- 评估多重移植的安全性和长期结果.
- 为了在不同数量的移植中比较移植存活率和患者死亡率.
- 为了确定移植重复接受者的成功预测因素.
主要方法:
- 对2000年至2019年期间进行的2152次脏移植进行了回顾性队列研究.
- 患者被分为三组:第一次移植 (n=1850),第二次移植 (n=285),以及三次或更多次移植 (n=75).
- 主要结局:死亡审查的移植失败和整体死亡率的组合. 二次结果:死亡审查的移植失败.
主要成果:
- 所有组的整体存活率 (死亡审查的移植失败和死亡率) 在所有组中都相似 (21.3%至25.2%,p=0.068).
- 死亡审查的移植失败仅在首次接受者中相比其他患者显著较低 (p=0.001).
- 在所有移植组中,活体供体状态是患者和移植存活的最强预测因素.
结论:
- 在第一次和多次移植接受者之间,移植和患者的存活率是可比的.
- 与首次接受者相比,多次移植的接受者表现出死亡审查的移植失败的风险较低.
- 年轻的患者,特别是那些从活体捐赠者获得脏的患者,应该考虑重复移植.
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