在肝移植中评估和管理心血管疾病
Matthew E Harinstein1, Caterina Gandolfo2, Salvatore Gruttadauria3,4
1Division of Cardiology, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
European heart journal
|August 16, 2024
概括
心脏病是肝移植 (LT) 候选人患有末期肝病 (ESLD) 的主要问题. 综合性心脏评估和管理对于优化结果和扩大LT资格至关重要.
科学领域:
- 肝病学和心脏病学.
- 移植医学 移植医学
背景情况:
- 末期肝病 (ESLD) 和肝移植 (LT) 接受者数量在全球范围内不断增加.
- 心脏病是LT后发病率和死亡率的主要原因,受人口老龄化和新陈代谢功能障碍相关的脂肪肝炎 (MASH) 病例增加的影响.
- 可治疗的心脏病的患病率,如冠状动脉疾病 (CAD) 和心肌病随着年龄的增长而增加,需要在LT候选人中进行治疗.
研究的目的:
- 为了解决证据的不足和对LT候选人的心脏评估和管理策略的差异.
- 为在术前和术后环境中管理心脏病提供指导.
- 通过改善心脏并发症复杂患者的评估,提高LT候选人接受度.
主要方法:
- 对ESLD患者的CAD查新兴文献的审查.
- 对LT候选人的心脏状况管理的专家经验和意见的综合.
- 专注于考虑ESLD独特生理学的多学科方法.
主要成果:
- 心脏评估和管理协议在移植中心之间存在显著差异.
- ESLD生理学独特地影响了手术前评估,术后护理和心脏病理的结果.
- 一个全面的,多学科的方法是管理心脏病在LT候选人的必不可少的.
结论:
- 需要标准化,基于证据的指导方针来对LT候选人的心脏评估和管理.
- 优化心脏护理可以增加合适的LT接受者的池.
- 需要进行进一步的研究,以填补心脏病患者LT患者综合护理的现有缺口.
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