受体和供体体重指数对肠道移植后生存结果的影响:器官共享联合网络数据库分析。

IF 1.1 4区 医学 Q3 SURGERY Annals of Transplantation Pub Date : 2024-07-09 DOI:10.12659/AOT.943994
Prince Addo Ameyaw, Sarpong Boateng, Eugene N Annor, Basile Njei
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引用次数: 0

摘要

背景与其他器官移植相比,肠移植术(IT)后患者的长期存活率仍然很低,尽管临床经验已积累多年。虽然体重指数(BMI)极高或极低的患者通常被认为不符合肠道移植的条件,但 BMI 对移植后肠道移植存活率的影响仍未得到充分研究。材料和方法 我们利用器官共享联合网络标准移植数据库,对 1994 年 4 月 11 日至 2021 年 9 月 29 日期间接受 IT 的患者进行了一项回顾性队列研究。我们使用 Kaplan-Meier 生存曲线以及单变量和多变量 Cox 回归分析评估了移植时受体和供体体重指数与移植后死亡率的关系。结果 共有 1541 名患者被纳入我们的最终样本。其中 806 名患者为女性(52.5%),大多数患者属于体重指数正常的亚组(54.2%)。肥胖 II 级患者(平均;36.8±10.92 岁)和体重不足患者(平均;37.6±13.37 岁)的年龄明显小于其他 BMI 类别的患者。调整后的多变量模型显示,与正常体重的 IT 受体相比,体重不足的 IT 受体的死亡风险增加(aHR=1.25,95% 置信区间 [CI],1.02-1.54;P=0.032)。结论 受体 BMI 低于正常值与肠道移植后死亡风险增加有关,是一种潜在的可改变患者特征以改善生存结果的方法。
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Impact of Recipient and Donor Body Mass Index on Survival Outcomes After Intestinal Transplantation: A United Network for Organ Sharing Database Analysis.

BACKGROUND Long-term patient survival after intestinal transplantation (IT) remains low compared with other organ transplants despite years of advancement in clinical experience. While patients with extremely high or low body mass index (BMI) are often considered ineligible for IT, the impact of BMI on post-transplant IT survival remains understudied. MATERIAL AND METHODS Using the United Network for Organ Sharing Standard Transplant database, we conducted a retrospective cohort study on patients who underwent IT between April 11, 1994, and September 29, 2021. We assessed the association of recipient and donor BMI at transplant with post-transplant mortality using Kaplan-Meier survival curves and univariate and multivariate Cox regression analyses. RESULTS A total of 1541 patients were included in our final sample. Of these patients, 806 were females (52.5%) and most were in the normal-weight BMI subgroup (54.2%). Obese class II (mean; 36.8±10.92 years) and underweight patients (mean; 37.6±13.37 years) were significantly younger than patients in other BMI categories. The adjusted multivariate model demonstrated an increased risk of mortality in underweight IT recipients compared to normal-weight IT recipients (aHR=1.25, 95% confidence interval [CI], 1.02-1.54; P=0.032).There was no significant association between donor BMI categories and survival in IT recipients. CONCLUSIONS Recipient BMI below normal is associated with an increased risk of mortality after intestinal transplantation and represents a potentially modifiable patient characteristic to improve survival outcomes.

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来源期刊
CiteScore
2.50
自引率
0.00%
发文量
79
审稿时长
>12 weeks
期刊介绍: Annals of Transplantation is one of the fast-developing journals open to all scientists and fields of transplant medicine and related research. The journal is published quarterly and provides extensive coverage of the most important advances in transplantation. Using an electronic on-line submission and peer review tracking system, Annals of Transplantation is committed to rapid review and publication. The average time to first decision is around 3-4 weeks. Time to publication of accepted manuscripts continues to be shortened, with the Editorial team committed to a goal of 3 months from acceptance to publication. Expert reseachers and clinicians from around the world contribute original Articles, Review Papers, Case Reports and Special Reports in every pertinent specialty, providing a lot of arguments for discussion of exciting developments and controversies in the field.
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