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捐赠者的动脉瘤性疾病是肝脏移植后肝动脉血栓症的危险因素

Javier M Zamora-Olaya^1,2, Rocío Tejero-Jurado^1,2, Paloma E Alañón-Martínez^1,2

¹Department of Hepatology and Liver Transplantation, Hospital Universitario Reina Sofía, Córdoba, Spain.

Clinical transplantation

|July 21, 2024

概括

肝移植接受者与捐赠者肝动脉 (HA) 动脉样硬化面临着明显更高的HA血栓形成的风险. 评估捐赠者HA血管结构可能会指导移植后的抗血小板治疗.

科学领域:

移植手术移植手术
血管病理学血管病理学
植入物评估的评估

背景情况:

增加捐赠者和接受者的年龄,以及代谢并发症,可能会增加肝移植后血管并发症的风险.
肝动脉 (HA) 动脉样硬化在捐赠者和接受者是肝移植后血栓形成的潜在危险因素.

研究的目的:

研究肝脏捐赠者和接受者的肝动脉动脉样硬化与移植后肝动脉血栓发生之间的关联.
确定肝移植中血管并发症,特别是HA血栓形成的危险因素.

主要方法:

一组443名成年肝移植患者 (2012-2021) 进行了对捐赠者和接受者HA动脉样硬化的盲目病理评估.
使用后勤回归和倾向分数匹配来评估HA动脉样硬化和HA血栓形成之间的关系.
排除标准包括部分/减少的移植,再移植和组合器官移植.

主要成果:

在51.5%的捐赠者和11.4%的接受者中发现了肝动脉动脉瘤.
肝动脉血栓发生在5.9%的患者中,从患有HA动脉样硬化症的捐赠者获得移植的患者中显著高 (10.7%vs0.8%).
供体HA动脉样硬化是HA血栓形成的独立风险因素 (OR=17.79,p=0.008),这一发现与倾向匹配分析 (OR=19.29,p=0.007) 一致. 接受者的动脉样硬化没有影响血栓形成风险 (OR=1.70,p=0.55).

结论:

供体肝动脉动脉样硬化是肝移植后肝动脉血栓形成的重要独立风险因素.
受体动脉样硬化似乎没有影响HA血栓形成的风险.
对于动脉样硬化,对供体移植血管的移植前评估可能会为术后抗血小板治疗策略提供信息.

关键词:

这是一个复杂的并发症.肝脏全移植功能/功能障碍血栓形成和血栓栓塞的发生.

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