解开复杂性:老年移植患者的发病率因素
Alexandra Gineste1, Paolo Malvezzi1, Thomas Jouve1,2
1Nephrology, Hemodialysis Apheresis and Kidney Transplantation, Department, CHU Grenoble Alpes, Grenoble, France.
Clinical kidney journal
|October 18, 2024
概括
老年患者 (70岁以上) 的移植结果表明,移植和供体因素,而不仅仅是年龄,影响生存率. 预防性和活体供体移植改善了老年接受者的结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植医学 移植医学
- 老年医学 老年医学
背景情况:
- 在老年人群中,末期病的患病率越来越高,需要在老年人群中进行移植.
- 虽然时间年龄不是移植资格的唯一决定因素,但接受者的脆弱性显著影响了移植后的结果,特别是在第一年内.
- 该RETRAITE研究侧重于70岁及以上的接受者移植结果.
研究的目的:
- 为了研究年长的接受者 (70岁及以上) 移植的结果.
- 在移植后的第一年内,在这个特定的患者群体中确定与发病率和死亡率相关的风险因素.
- 为了比较老年人和年轻的移植接受者之间的结果.
主要方法:
- 对149名年龄在70岁以上的移植接受者进行了回顾性队列研究,这些人于2015年至2020年间进行了移植.
- 定义了一个复合初级终点,包括长时间住院 (>40天),死亡或在移植后的第一年内恢复透析.
- 将数据与150名年轻脏移植接受者的队列合并,以验证发现.
主要成果:
- 在老年人队伍中观察到1年的移植存活率为87.9%.
- 33%的老年接受者在第一年内达到复合终点.
- 与复合终点的显著关联包括治疗性抗凝药,外围动脉病变和延迟的移植功能. 透析时间,长期冷血缺血和供体年龄增加了发病率/死亡率,而预防性和活体供体移植降低了它们.
结论:
- 接受者年龄本身在统计学上与70岁以上的移植接受者患病率和死亡率的增加没有相关性.
- 与移植和供体相关的变量,特别是治疗性抗凝药,与较差的结果有关.
- 预防性和活体捐赠者的移植证明了对老年接受者的发病率和死亡率产生有利影响.
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