在老年人中进行脏再移植:好处值得冒风险吗?
Syed S Mujtahedi1, Colleen L Jay1, Natalia Sakhovskaya2
1Department of Surgery, Section of Transplantation, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina, USA.
Clinical transplantation
|March 10, 2025
概括
与初级脏移植 (PrKT) 相比,接受脏再移植 (ReKT) 的老年患者面临着更高的死亡风险. 然而,死亡审查的移植存活率在两组之间仍然相似.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 移植手术 移植手术
- 老年医学 老年医学
背景情况:
- 越来越多的老年患者正在接受移植.
- 在这个人口群体中,进行一次性移植 (PrKT) 和再移植 (ReKT).
- 了解老年接受者的结果对于优化护理至关重要.
研究的目的:
- 为了比较已故捐赠者脏再移植 (ReKT) 与老年患者 (65岁以上) 的初级脏移植 (PrKT) 的结果.
- 为了评估患者的生存率,移植的生存率,以及在这个人群中移植损失的原因.
主要方法:
- 在老年患者中对已故捐赠脏移植 (DDKTs) 的回顾性队列研究.
- 分析包括从2004年12月到2022年8月的668个DDKT.
- 在39个ReKT和629个PrKT之间进行比较.
主要成果:
- 接受ReKT的患者的捐赠者年轻,KDPI较低,CPRA水平较高.
- 主要非功能和延迟的移植功能率在ReKT和PrKT组之间是可比的.
- 在ReKT (55.2%) 和PrKT (74.3%) 中,患者的五年生存率较低. 在ReKT (59%) 和PrKT (37.4%) 中,功能移植 (DWFG) 的死亡率更高,占大多数移植损失.
- 死亡审查的移植存活率相似 (62.5%的ReKT与68.3%的PrKT).
结论:
- 已故捐赠者ReKT的老年接受者患DWFG的风险增加.
- 尽管DWFG率较高,但ReKT的死亡审查结果与年龄相匹配的PrKT接受者相似.
- 这些发现凸显了在老年移植候选人中考虑移植质量和患者的并发病的重要性.
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