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评估65岁以上患者使用高KDPI脏的预防性脏移植的结果,与非预防性接受者相比
Siavash Safiee1, Mahmoudreza Moein2, Isabel Sia2
1Tehran Medical Branch, Islamic Azad University, Tehran, Iran.
International urology and nephrology
|August 16, 2025
概括
老年人可以从脏移植 (KT) 中受益,使用高脏捐赠者概况指数 (KDPI) 的脏. 预防性KT提供了更好的结果,即使是高KDPI器官,突显了移植时间的重要性,以改善患者的生存率.
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:
- 脏捐赠者个人资料指数 (KDPI) 评分可以分层脏全移植质量.
- 患有末期病 (ESKD) 的老年患者 (≥65岁) 可能受益于移植 (KT).
- 高KDPI脏 (≥85) 往往未得到充分利用,但对于某些患者群体可能是可行的.
研究的目的:
- 评估接受高KDPI脏的老年人 (≥65岁) 预防性与非预防性脏移植的结果.
- 为了比较不同KDPI层的老年接受者的预防性和非预防性KT之间的移植存活率和患者存活率.
- 确定移植时间对接受高风险捐赠脏的老年患者结果的影响.
主要方法:
- 使用移植受体科学注册 (SRTR) 数据库 (2000-2023) 进行回顾性队列研究.
- 分析包括65岁及以上的已故捐赠者移植患者,但不包括先前移植或缺失KDPI数据的患者.
- 患者被分为四组:高KDPI预防性,低KDPI预防性,高KDPI非预防性和低KDPI非预防性. 时间到事件模型评估了移植损失和死亡.
主要成果:
- 与低KDPI的预防性移植相比,高KDPI的非预防性移植显示出死亡审查的全移植失败 (HR:2.89) 和患者存活率 (HR:1.80) 的最差结果.
- 高KDPI的预防性移植与低KDPI的预防性移植相比结果更差,但比高KDPI的非预防性移植更好.
- 不管KDPI得分如何,非预防性组与预防性组相比,移植和患者存活率一般都较差.
结论:
- 老年人可以从使用高KDPI脏的脏移植中受益.
- 预防性移植与老年接受者的更好的长期结果有关,即使使用高风险的捐赠脏.
- 移植时间是优化老年移植接受者的结果的关键因素,特别是在使用边际捐赠者全移植时.
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