年龄和肝移植:临床结果的关键因素? 阿根廷的单个中心研究
Marco Santillán Pazmiño1, Paula Constanza Arriola Benitez2, Maria Florencia Fernandez3
1Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB- CONICET- Universidad Favaloro), Buenos Aires, Argentina.
Frontiers in aging
|December 29, 2025
概括
使用老年捐赠者进行肝移植 (LTx) 的情况正在增加,但捐赠者的年龄会影响结果. 老年捐赠肝脏的炎症和衰老程度较高,导致患者和移植的存活率降低,这凸显了在器官选择中需要考虑生物年龄的必要性.
科学领域:
- 肝病学和移植外科手术
- 老年学和衰老研究研究.
- 免疫学和分子生物学
背景情况:
- 肝移植 (LTx) 的需求日益增加,需要使用来自老年捐献者的器官.
- 在阿根廷,关于捐赠者年龄对LTx后结果的影响的数据有限.
研究的目的:
- 评估供体年龄对LTx.后临床,功能和分子结果的影响.
- 分析年轻人与老年捐赠肝脏的接受者生存率,早期并发症,肝功能和分子标记.
主要方法:
- 对267名LTx (2009-2020年) 的回顾性队列研究,将捐赠者分为年轻 (18-59岁) 和老年 (≥60岁) 组.
- 生存分析 (卡普兰-梅尔,考克斯回归) 调整为多个共变量.
- 评估早期的全移植功能障碍,替代疗法,肝功能测试,基因表达 (促炎和衰老标志物) 和脂素沉积.
主要成果:
- 老年捐赠者接受者的整体和移植存活率 (OS和GS) 显著降低.
- 捐赠者的年龄独立地预测了GS和OS,以及接受者的年龄和总 bilirubin (TBIL).
- 在早期的异位移植功能障碍或替代疗法中没有差异;然而,老年捐赠肝脏显示出更高的炎症/衰老标志物和脂素积累.
结论:
- 供体肝脏衰老,以增加炎症和衰老为标志,与LTx后患者和移植存活率较差有关.
- 这些发现强调了在器官分配策略中考虑捐赠者的生物年龄的重要性.
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