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Lancet:ABO不相容的肾移植预后研究

2019-04-20 MedSci MedSci原创

研究发现尽管ABO不相容的肾移植在临床管理方面取得了进展,但在移植后的头3年内,移植肾患者的死亡率及移植物存活率均低于全体相容移植,只有5年后的长期结果才能产生相同的存活率和器官功能。认识到感染、器官排斥和出血的风险增加,可以改善病人的护理,并促进配对肾脏交换方案的发展

ABO不相容肾移植(ABOi-rTx)的临床应用越来越多。与ABO兼容的肾移植(ABOc-rTx)相比,其移植早期或后期的非劣性证据尚不充分。近日研究人员就ABOi-RTX和ABOc-RTX的预后差异进行了考察。

研究对截至2017年12月31日发表的观察性研究进行了系统的回顾和荟萃研究,这些研究报告了ABOi -rTx后的结果数据(≥1年随访),并包括ABO兼容的对照组。主要终点是移植后1年、3年、5年和8年以上的全因死亡率和移植物存活率。

65063名患者参与研究,其中7098例进行了ABOi-rTx。与ABOc-rTx组相比,ABOi-rTx患者移植后1年 (OR=2.17,I2=37%),3年(OR= 1.89,I2=29%)和5年(OR=1.47,I2=68%)的死亡率显著升高。在1年(OR=2.52,I2=61%)和3年(OR=1.59,I2=58%)时,ABOi-rTx的移植存活率低于ABOc-rTx。5-8年后ABOi-rTx与ABOc-rTx的患者生存率相当。移植后5年内未发现发表偏倚,试验序列分析结果可靠,此后数据无效或无结论。

研究发现尽管ABO不相容的肾移植在临床管理方面取得了进展,但在移植后的头3年内,移植肾患者的死亡率及移植物存活率均低于全体相容移植,只有5年后的长期结果才能产生相同的存活率和器官功能。认识到感染、器官排斥和出血的风险增加,可以改善病人的护理,并促进配对肾脏交换方案的发展。

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    2020-01-29 howi
  2. [GetPortalCommentsPageByObjectIdResponse(id=1830035, encodeId=6fa81830035cc, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Wed Jan 29 06:19:00 CST 2020, time=2020-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1598024, encodeId=4c7e1598024dc, content=<a href='/topic/show?id=6c6f1e62c5' target=_blank style='color:#2F92EE;'>#ABO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1762, encryptionId=6c6f1e62c5, topicName=ABO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b6c918580135, createdName=闆锋旦, createdTime=Sun Apr 21 21:19:00 CST 2019, time=2019-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364941, encodeId=f10236494128, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Apr 20 08:27:17 CST 2019, time=2019-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364930, encodeId=c46f36493078, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Sat Apr 20 06:49:44 CST 2019, time=2019-04-20, status=1, ipAttribution=)]
    2019-04-21 闆锋旦
  3. [GetPortalCommentsPageByObjectIdResponse(id=1830035, encodeId=6fa81830035cc, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Wed Jan 29 06:19:00 CST 2020, time=2020-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1598024, encodeId=4c7e1598024dc, content=<a href='/topic/show?id=6c6f1e62c5' target=_blank style='color:#2F92EE;'>#ABO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1762, encryptionId=6c6f1e62c5, topicName=ABO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b6c918580135, createdName=闆锋旦, createdTime=Sun Apr 21 21:19:00 CST 2019, time=2019-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364941, encodeId=f10236494128, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Apr 20 08:27:17 CST 2019, time=2019-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364930, encodeId=c46f36493078, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Sat Apr 20 06:49:44 CST 2019, time=2019-04-20, status=1, ipAttribution=)]
    2019-04-20 龙胆草

    学习谢谢分享

    0

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    2019-04-20 深海的鱼

    学习学习学习

    0

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