在正常热区域输液期间的肝功能最大容量测试可以预测移植后的移植功能
Ivo J Schurink1, Femke H C de Goeij1, Fenna J van der Heijden1
1Division of HPB and Transplant Surgery, Department of Surgery, Erasmus MC Transplant Institute, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, Zuid Holland The Netherlands.
The EPMA journal
|September 6, 2024
概括
肝脏最大容量 (LiMAx) 测试客观地评估了在腹部正常热区域输液 (aNRP) 期间的供体肝功能. 这种创新方法有助于预防移植后的并发症,因为它可以为肝移植提供个性化的捐赠者-接受者匹配.
科学领域:
- 移植免疫学 移植免疫学
- 器官的保存 器官的保存
- 手术方面的创新.
背景情况:
- 扩展标准捐赠器官,包括循环死亡 (DCD) 后的捐赠,越来越多地用于打击移植等候名单死亡率.
- 目前的风险评估依赖于通用的名录,缺乏对个体捐赠器官评估的准确性.
- 腹部正常热区域输液 (aNRP) 允许在现场进行器官评估,但需要确定的功能黄金标准.
研究的目的:
- 评估使用肝脏最大容量 (LiMAx) 试验的可行性,以客观地评估aNRP期间的肝功能.
- 确定LiMAx测量是否可以预测供体肝脏的适用性,并预防移植后并发症.
- 建立一个个性化的方法来将捐赠者的肝脏与接受者匹配.
主要方法:
- 腹部正常热区域输液 (aNRP) 在18个循环死亡 (DCD) 肝移植后的捐赠中进行.
- 肝脏最大容量测试 (LiMAx) 被集成到aNRP电路中,用于实时评估肝功能.
- 分析了连续变量,呈现数据为中位数与四分位数间范围.
主要成果:
- 在94%的aNRP程序中,LiMAx测试成功执行.
- 更高的LiMAx得分与更好的乳酸清除相关,并且在aNRP期间在肝脏中观察到压力高血糖症.
- 利马克斯评分准确地区分了为移植选择的肝脏和丢弃的肝脏,显示出与AST和ALT水平的强烈相关性.
结论:
- 在aNRP期间,LiMAx测试可用于评估个体捐赠者的肝功能.
- LiMAx提供了一个客观的衡量方法来预测肝功能和潜在的并发症,从而实现个性化的捐赠者与接受者匹配.
- 这种测试可以提高供体肝脏的选择,减少移植后的并发症,并个性化肝脏移植的结果.
相关概念视频
01:11Observational Studies
Observational studies are a type of analytical study where researchers observe events without any interventions. In other words, the researcher does not influence the response variable or the experiment's outcome.
There are three types of observational studies – Prospective, retrospective, and cross-sectional.
Prospective Study
Prospective studies, also known as longitudinal or cohort studies, are carried out by collecting future data from groups sharing similar characteristics. One example of...
There are three types of observational studies – Prospective, retrospective, and cross-sectional.
Prospective Study
Prospective studies, also known as longitudinal or cohort studies, are carried out by collecting future data from groups sharing similar characteristics. One example of...
01:30Methods of Documentation VII: EMR
Electronic Medical Records (EMRs) primarily center around electronically documenting patients' health information within a single healthcare organization or practice. They contain essential clinical data related to a patient's medical history, diagnoses, medications, treatment plans, lab results, and other pertinent information relevant to the specific encounter or episode of care. EMRs are designed to streamline documentation and workflow processes within individual healthcare settings,...
01:29Documentation in Long-Term and Home Healthcare Setting
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
01:26Introduction to Epidemiology
Epidemiology, known as the cornerstone of public health, involves studying the distribution and determinants of health-related events in defined populations and applying these insights to control health issues. This is essential for understanding how diseases spread, identifying populations at greater risk, and implementing measures to control or prevent outbreaks. Epidemiology addresses not only infectious diseases but also non-communicable conditions like cancer and cardiovascular disease,...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...