在儿科患者群体中,移植后结果与捐赠者心脏缺血时间延长的结果
Shannon Oliver1, Jennifer Conway1, Michael Khoury1
1Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
概括
儿童心脏移植 (HTx) 结果不会受到更长的缺血时间 (IT) 的负面影响. 这项研究没有发现心脏移植受体患有超过6小时缺血时间的移植失败或发病风险增加.
科学领域:
- 心脏病学 心脏病学
- 移植手术 移植手术
- 儿科医学 儿科医学
背景情况:
- 目前的指导方针建议不要使用超过6小时的缺血时间 (IT) 的供体心脏进行儿科心脏移植 (HTx).
- 关于长时间IT对儿科HTx结果的影响的数据有限,特别是来自地理偏远的中心.
研究的目的:
- 评估儿科心脏移植 (HTx) 接受者的缺血时间 (IT) 和临床结果之间的关联.
- 确定IT是否是该人群中移植失败或发病的独立风险因素.
主要方法:
- 在1995年1月至2020年12月期间接受心脏移植的188名儿科患者的回顾性单中心分析.
- 患者被分为三个IT组:<4.5小时,4.5-6小时和>6小时.
- 考克斯比例危险建模用于评估与移植失败相关的因素.
主要成果:
- 缺血时间在整个队列中均分布 (37.2%对31.4%对31.4%).
- 在IT组之间没有观察到早期HTx后发病率的显著差异,包括初级移植功能障碍.
- 长时间的IT (>6小时) 与IT <4.5小时 (HR 1.10,P = .797) 相比,与移植失败的风险增加无关.
结论:
- 在这个队列中,缺血时间不是心脏移植后发病率或移植失败的独立风险因素.
- 使用经过修改的del Nido保存解决方案和机构经验可能有助于长期IT的成功结果.
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