70岁以上患者的肝移植
Tércio Genzini1,2,3,4, Marina Guitton Rodrigues4, Thais Natalia de Almeida4
1Hospital Alemao Oswaldo Cruz, Liver Transplant Unit - São Paulo (SP), Brazil.
概括
对于70岁及以上的患者来说,肝移植是安全的,结果与年轻的接受者相似. 在老年人中, 精心选择供体是成功移植肝脏的关键.
科学领域:
- 肝病学
- 移植手术
- 老年医学
背景情况:
- 肝移植对于老年人群来说是一个可行的治疗方法,
- 在老年接受者中,精心选择和评估是成功治疗的关键.
研究的目的:
- 与年轻患者相比,评估70岁及以上患者的肝移植 (LT) 的有效性.
- 为了确定晚年是否应该是LT的禁忌.
主要方法:
- 对309名肝移植患者进行了回顾性分析.
- 患者分为两组:年龄在69岁以下和70岁以上.
- 这些组对捐赠者特征,术后数据和存活率进行了比较.
主要成果:
- 虽然老年接受者 (II组) 需要更高的输血和更长的重症监护室 (ICU) 停留,但90天的存活率与年轻的接受者 (I组) 相似.
- 捐赠者的特征在各组之间是相似的,在I组中发现了较高的上腺素剂量.
- 第二组的营养不良和并发病率较高.
结论:
- 在70岁及以上的患者中,肝移植是可行的和有效的.
- 老年患者不应被排除在移植等待名单上,分配政策可能需要调整.
- 相似的结果表明,仅仅是晚年并不妨碍LT候选人.
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