在心脏移植之前和之后对结肠直肠癌的查和监测
Madeline E Abrams1, Eleanor Keller1, Carolina Lemos1
1Department of Medicine, New York Presbyterian-Columbia University Irving Medical Center, New York, New York, USA.
Clinical transplantation
|September 18, 2025
概括
心脏移植接受者在移植前显示高结肠直肠癌 (CRC) 查率,但移植后查完成率较低. 为了在这个人群中找到最佳的CRC查指南,需要进一步的研究.
科学领域:
- 移植医学 移植医学
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
背景情况:
- 固体器官移植增加了恶性瘤的风险,由于免疫抑制.
- 目前对心脏移植 (HT) 候选人和接受者的结直肠癌 (CRC) 查指南反映了一般人群的建议.
- 需要评估在HT接受者移植前和移植后的CRC查实践.
研究的目的:
- 评估心脏移植 (HT) 候选人和接受者遵守CRC查指南.
- 分析在移植前和移植后的HT接受者中CRC查方法和结果.
- 确定影响HT接受者CRC查完成的因素.
主要方法:
- 成年HT接受者的回顾性队列研究 (2013-2023) 在一个大体积移植中心.
- 数据收集包括人口统计,实验室结果,机械循环支持 (MCS) 的使用,以及从电子医疗记录中使用的CRC查方法.
- 多变量后勤回归分析了结肠镜检查前和后的结肠镜检查使用的预测因素.
主要成果:
- 在650名HT接受者中,88.5%接受了HT前的CRC查,结肠镜检查是主要方法 (88.6%).
- 在符合条件的患者中,HT后查完成率为51.8%.
- 在HT前的26.6%和HT后的19.3%的查中检测到腺瘤多;CRC发生率为HT后的1.2%.
结论:
- 很大一部分HT接受者在移植前接受CRC查,但移植后的坚持不够理想.
- 机械循环支 (MCS) 的使用与HT前更低的结肠镜利用率有关.
- 对心脏移植前和之后的人群的最佳CRC查策略需要进一步研究.
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