特殊凝血研究在同期胰肾联合移植术前血栓形成并发症筛查中的作用
Role of Special Coagulation Studies for Preoperative Screening of Thrombotic Complications in Simultaneous Pancreas-Kidney Transplantation.
作者信息
Moiz Abdul, Javed Tariq, Bohorquez Humberto, Bruce David S, Carmody Ian C, Cohen Ari J, Staffeld-Coit Catherine, Luo Qingyang, Loss George E, Garces Jorge
机构信息
Department of Nephrology, Ochsner Clinic Foundation, New Orleans, LA ; Multi-Organ Transplant Institute, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
Department of Nephrology, Ochsner Clinic Foundation, New Orleans, LA.
出版信息
Ochsner J. 2015 Fall;15(3):272-6.
BACKGROUND
Vascular thrombosis is a well-known complication after simultaneous pancreas-kidney (SPK) transplantation procedures. The role of preoperative special coagulation studies to screen patients at high risk for vascular thrombosis is unclear and not well studied.
METHODS
This study reports a retrospective medical record review of 83 SPK procedures performed between April 2007 and June 2013 in a single institution. All SPK transplantation recipients underwent preoperative screening for hypercoagulable state.
RESULTS
Eighteen of 83 patients (21.69%) were diagnosed with vascular thrombosis of the pancreas. Of the 23 patients with at least 1 positive screening test, only 4 had a thrombotic event (17.39%). On the other hand, 14 of 60 patients with negative screening tests developed vascular thrombosis (23.33%). The hypercoagulable screening workup had a positive predictive value of 17.39% and a negative predictive value of 76.67%. The workup also demonstrated low sensitivity (22.22%) and specificity (70.77%).
CONCLUSION
No differences were seen in patient or graft survival between groups at 12 months. This retrospective study did not show any benefit of using special coagulation studies to rule out patients at risk for vascular thrombosis after SPK transplantation.
背景
血管血栓形成是胰肾联合移植（SPK）术后一种众所周知的并发症。术前进行特殊凝血检查以筛查血管血栓形成高危患者的作用尚不清楚，且研究较少。
方法
本研究报告了对2007年4月至2013年6月在单一机构进行的83例SPK手术的回顾性病历审查。所有SPK移植受者均接受了术前高凝状态筛查。
结果
83例患者中有18例（21.69%）被诊断为胰腺血管血栓形成。在23例至少有1项筛查试验阳性的患者中，只有4例发生血栓事件（17.39%）。另一方面，60例筛查试验阴性的患者中有14例发生了血管血栓形成（23.33%）。高凝筛查检查的阳性预测值为17.39%，阴性预测值为76.67%。该检查的敏感性（22.22%）和特异性（70.77%）也较低。
结论
12个月时两组患者或移植物生存率无差异。这项回顾性研究未显示使用特殊凝血检查来排除SPK移植后血管血栓形成高危患者有任何益处。
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