在精心挑选的III类肥胖患者中进行肝移植的结果很好
Kevin Yi1,2, Vicki Avery1, John McCall1,2
1New Zealand Liver Transplant Unit, Auckland City Hospital, Te Toka Tumai, Auckland, New Zealand.
Clinical transplantation
|January 13, 2025
概括
肥胖患者的肝移植结果与非肥胖个体相似. 严格的选择确保了接受肝移植的III类肥胖患者的短期和长期生存率相似.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植手术 移植手术
- 肥胖医学 肥胖医学
背景情况:
- 以前的指导方针对40kg/m2以上的体重指数 (BMI) 进行肝移植 (LT) 是禁忌的.
- 肥胖症是需要LT的患者日益关注的问题.
- 了解肥胖人口的结果对于完善LT标准至关重要.
研究的目的:
- 评估接受LT的肥胖患者的选择过程和结果.
- 为了比较不同类型的肥胖 (I,II和III类) 的结果.
- 为了评估肥胖与非肥胖的LT接受者的长期存活率.
主要方法:
- 对315名被评估为LT的肥胖患者 (2010-2023) 的回顾性分析.
- 患者分为I类 (BMI 30-34.9),II类 (BMI 35-39.9) 和III类 (BMI >40 kg/m2) 的患者.
- 结果与非肥胖成年患者的结果进行比较.
主要成果:
- 168名患者进行了移植;25名患者患有III级肥胖症.
- 在所有肥胖类别中,术后并发症 (Clavien-Dindo等级≥3) 没有显著差异.
- 在肥胖和非肥胖群体中观察到相同的5年患者和移植存活率 (p=0.932).
结论:
- 严格的选择使得III类肥胖患者的短期LT结果可以比较.
- 在LT后的长期存活率在肥胖和非肥胖患者中是相同的.
- 目前的指导方针可能在LT候选人的肥胖问题上过于严格.
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