在70岁及以上的患者同时进行肝脏和脏移植:谨慎进行
Daniel M Kaufman1, James D Perkins1,2, Ramasamy Bakthavatsalam1
1Division of Transplant Surgery, Department of Surgery, University of Washington, Seattle, WA.
Transplantation direct
|July 22, 2024
概括
70岁以上的老年患者同时接受肝脏和脏 (SLK) 移植的生存率较低. 肝移植后的脏可能是一个更好的选择,以避免在这个年龄段的徒劳移植.
科学领域:
- 移植免疫学 移植免疫学
- 老年医学 老年医学
- 器官衰竭管理 器官衰竭管理
背景情况:
- 与代谢功能障碍相关的脂肪肝炎的患病率越来越高,导致肝脏和功能衰竭的老年患者数量不断增加.
- 关于在政策实施后同时接受肝脏和脏移植 (SLK) 的老年患者结果的数据有限.
- 专注于年龄在70岁及以上的越来越多的患者,需要复杂的器官支持.
研究的目的:
- 评估老年患者 (70岁以上) 同时肝脏和脏 (SLK) 移植的结果.
- 为了比较老年SLK接受者与年轻接受者以及接受单独移植或肝移植后移植的接受者之间的患者和移植存活率.
- 评估SLK分配政策对这一人口群体的影响.
主要方法:
- 对器官采购和移植网络 (OPTN) 数据库的回顾性分析.
- 包括2017年8月至2022年12月期间接受SLK或移植的成年患者 (18岁以上).
- 对不同年龄组和移植类型的生存结果进行比较.
主要成果:
- 从2017年到2021年,70岁以上患者的SLK移植显著增加.
- 与年轻人群相比,70岁以上的接受者1年 (82.9%) 和3年 (66.5%) 的生存率较低.
- 在70岁以上的患者群体中,合移植的存活率明显较低 (在1年后为80.9%,在3年后为66.4%) 与仅接受脏移植的患者相比 (在1年后为91.1%,在3年后为75.5%).
- 对于SLK与移植后肝移植接受者的移植生存率没有显著差异.
结论:
- 70岁及以上的SLK移植接受者的结果较差.
- 仅仅是时间学年龄不应该成为考虑移植的障碍.
- 肝移植后的移植可能是一个可行的策略,以防止某些老年患者的非有益的移植.
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