活体供体肝移植后的生存与接受者全身炎症和身体组成之间的关联
Jae Hwan Kim1, Yeon Ju Kim2, Hye-Mee Kwon2
1Department of Anesthesiology and Pain Medicine, Inje University Haeundae Paik Hospital, Busan 48108, Republic of Korea.
Journal of clinical medicine
|August 28, 2025
概括
通过中性粒细胞与淋巴细胞比率 (NLR) 测量,手术前的肉类和高系统性炎症状态显著增加了肝移植患者的死亡风险. 结合这些因素可以预测移植后的存活率.
科学领域:
- 肝病学
- 移植手术
- 老年病学
背景情况:
- 手术前的肉是肝移植 (LT) 结果不佳的已知预测因素.
- 系统性炎症状态 (SIS) 与骨肌肉损失有关,这表明对LT预后的结合效应.
- 评估SIS和肉可能会改善LT受者的风险分层.
研究的目的:
- 研究SIS和骨肌肉指数 (SMI) 与活体供体肝移植 (LDLT) 接受者的死亡率之间的关系.
- 评估LDLT后的短期和长期存活率的和SIS的综合预后值.
主要方法:
- 对3387名成人LDLT接受者的回顾性分析.
- 中性细胞与淋巴细胞的比率 (NLR > 3) 用作SIS的标记.
- 骨肌肉指数 (SMI) 根据CT扫描计算,并按性别划分.
- 进行单变量和多变量Cox比例危险分析.
主要成果:
- 减少SMI与增加NLR相关.
- 增加NLR和减少SMI都与90天死亡率存在剂量依赖的关联.
- 与NLR> 3相结合的萨科佩尼亚独立预测了更高的90天和整体死亡率 (HR分别为2. 48和1. 81).
- 萨科佩尼亚与死亡率之间的关联在各个子组中持续存在,尤其在女性中更高.
结论:
- 术后的90天和整体死亡风险显著增加,几乎是危险的两倍.
- 这些随时可用的生物标志物为预测LT存活率提供了实用指标.
- 解决这些潜在的可改变因素可能是改善LT后治疗结果的治疗目标.
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