在移植后早期输血的临床影响
Minyu Kang1, Hwa-Hee Koh1, Seung Hyuk Yim2
1Departments of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
Scientific reports
|February 25, 2025
概括
在移植后早期输血红细胞增加了患者死亡,移植损失和排斥的风险. 这表明需要重新评估目前对移植受体的输血实践.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植免疫学 移植免疫学
- 临床医学 临床医学
背景情况:
- 已知移植前红细胞输血 (RBCT) 会导致全敏感化.
- 移植后使用的RBCT的影响仍然是争论的主题.
研究的目的:
- 评估早期RBCT (移植后30天内) 对患者和移植结果的长期影响.
- 确定早期RBCT与移植接受者的不良临床事件之间的关联.
主要方法:
- 从2014年到2020年,对785名接受HLA和ABO兼容移植的患者进行了回顾性分析.
- 患者根据早期RBCT的管理进行了分层.
- 进行多变量分析和敏感性分析以评估结果.
主要成果:
- 早期RBCT给了18.9%的患者.
- 早期的RBCT独立地与所有原因死亡率 (HR 2.264) 和死亡审查的移植损失 (HR 1.995) 的风险增加有关.
- 在接受早期RBCT的患者中,抗体中介排斥的累积发病率显著更高 (P=0.024).
结论:
- 早期移植后的RBCT与较高的死亡风险,移植损失和抗体中介排斥有关.
- 这些发现需要对移植后的输血方案进行批判性审查.
- 仔细考虑输血时间和必要性对于优化移植患者的长期结果至关重要.
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