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肝移植患者心血管风险分层:平衡临床结果和资源分配

Luca Galassi¹, Martina Spanevello², Matteo Lino Ravini³

¹School of Vascular and Endovascular Surgery, University of Milan, Milan 20122, Lombardy, Italy. luca.galassi@unimi.it.

World journal of transplantation

|December 8, 2025

概括

肝移植候选人面临影响生存的心血管风险. 具有成本效益的查策略对于管理心血管风险 (CVR) 和改善公共卫生保健系统内的患者结果至关重要.

科学领域:

心脏病学心脏病学
移植医学移植医学
卫生经济学卫生经济学

背景情况:

心血管疾病 (CVD) 对肝移植候选人构成重大风险,影响生存率并导致术后并发症.
患有高血压,糖尿病和脂质失调等心血管风险 (CVR) 因素的患病率在这一群体中很高,增加了事件率.
现有的CVR分层指南的应用不一致,部分原因是综合性心血管评估的高成本.

研究的目的:

突出肝移植候选人心血管风险分层方面的挑战,特别是公共卫生保健中的成本和资源配置问题.
强调需要基于证据的,具有成本效益的策略,用于肝移植接受者的心血管评估.
倡导适应性协议,在移植计划中平衡患者安全与经济可持续性.

主要方法:

对肝移植候选人的心血管风险分层现行指南和临床实践的审查.
对综合性心血管评估对公共卫生保健系统的经济影响的分析.
探索CVR因子,手术结果和肝移植接受者的长期生存之间的联系.

主要成果:

对CVR分层指南的不一致应用导致患者管理不足.
与先进的诊断测试和专家咨询相关的高成本构成了障碍,特别是在资源有限的公共卫生机构中.
对CVR因子的有效管理对于改善肝移植候选人的生存率和减少主要心血管事件至关重要.

结论:

迫切需要更新,基于证据的实践,用于肝移植候选人的心血管评估,这些实践既临床有效,又经济可行.
需要可适应的协议来优化移植的安全性和有效性,同时解决公共卫生系统的财务限制.
为了实现可持续的肝移植计划,要平衡彻底的心血管查与高效的资源利用是必不可少的.

关键词:

进行成本效益分析.肝脏移植肝脏移植资源分配资源的分配.风险评估风险评估风险评估心血管疾病心血管疾病

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