Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Transpl Int. 2017 Nov;30(11):1161-1171. doi: 10.1111/tri.13010. Epub 2017 Aug 3.
Although organ transplantation is the definitive treatment for end-stage organ failure, the post-transplant outcomes can be substantially influenced by cardiovascular complications. A national cohort study was performed to estimate risks of cardiovascular diseases in those with heart, lung, kidney, and liver transplantation. This cohort study consisted of 5978 solid organ transplantations identified using the Taiwan National Health Insurance Database. Cardiovascular and mortality risks in transplant recipients were evaluated using standardized incidence ratios, excess absolute risks, and standardized mortality ratios as compared to those in the general population. In heart, kidney, and liver recipients, the standardized incidence ratios of overall cardiovascular diseases were 9.41 (7.75-11.44), 3.32 (2.29-3.77), and 1.4 (1.15-1.7) and the overall standardized mortality ratios were 5.23 (4.54-6.03), 1.48 (1.34-1.63), and 3.95 (3.64-4.28), respectively. Except for heart organ recipients who were at highest risk for coronary artery disease with a standardized incidence ratio of 13.12 (10.57-16.29), kidney and liver organ recipients had a ninefold increased risk in developing deep vein thrombosis post-transplant. In conclusion, solid organ transplant patients are at risk of cardiovascular disease, in particular, deep vein thrombosis, which may warrant early identification of high-risk patients in addition to prompt and adequate thromboprophylaxis perioperatively.
尽管器官移植是治疗终末期器官衰竭的确定性方法，但移植后的结果可能会受到心血管并发症的极大影响。进行了一项全国性队列研究，以估计患有心脏、肺、肾和肝移植的患者发生心血管疾病的风险。该队列研究包括使用台湾全民健康保险数据库确定的 5978 例实体器官移植。通过标准化发病率比、超额绝对风险和标准化死亡率与普通人群进行比较，评估了移植受者的心血管和死亡率风险。在心脏、肾脏和肝脏受者中，总体心血管疾病的标准化发病率比分别为 9.41（7.75-11.44）、3.32（2.29-3.77）和 1.4（1.15-1.7），总体标准化死亡率比分别为 5.23（4.54-6.03）、1.48（1.34-1.63）和 3.95（3.64-4.28）。除了心脏器官受者患冠状动脉疾病的标准化发病率比为 13.12（10.57-16.29）的风险最高外，肾脏和肝脏器官受者在移植后发生深静脉血栓形成的风险增加了九倍。总之，实体器官移植患者存在心血管疾病风险，特别是深静脉血栓形成，这可能需要除了围手术期及时和充分的血栓预防之外，还需要早期识别高危患者。
