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肝移植和肾移植受者的输血状况——来自全国索赔数据库的结果

Transfusion Status in Liver and Kidney Transplantation Recipients-Results from Nationwide Claims Database.

作者信息

Park Boyoung, Yoon Junghyun, Kim Han Joon, Jung Yun Kyung, Lee Kyeong Geun, Choi Dongho

机构信息

Department of Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea.

Graduate School of Public Health, Hanyang University, Seoul 04763, Korea.

出版信息

J Clin Med. 2020 Nov 10;9(11):3613. doi: 10.3390/jcm9113613.

Abstract

BACKGROUND

This study analyzed the status and trends of transfusion and its associated factors among liver and kidney transplantation recipients.

METHODS

A total of 10,858 and 16,191 naïve liver or kidney transplantation recipients from 2008 to 2017 were identified through the National Health Insurance Service database. The prescription code for transfusion and the presence, number, and amount of each type of transfusion were noted. The odds ratios and 95% confidence intervals were determined to identify significant differences in transfusion and blood components by liver and kidney transplantation recipient characteristics.

RESULTS

In this study, 96.4% of liver recipients and 59.7% of kidney recipients received transfusions related to the transplantation operation, mostly platelet and fresh frozen plasma. Higher perioperative transfusion in women and declining transfusion rates from 2008 to 2017 were observed in both liver and kidney recipients. In liver recipients, the transfusion rate in those who received organs from deceased donors was much higher than that in those who received organs from living donors; however, the mortality rate according to transfusion was higher only in recipients of deceased donor organs. In kidney recipients, a higher mortality rate was observed in those receiving transfusion than that in patients without transfusion.

CONCLUSIONS

In Korea, the transfusion rates in liver and kidney recipients were relatively higher than those in other countries. Sociodemographic factors, especially sex and year of transplantation, were associated with transfusion in solid organ recipients, possibly as surrogates for other causal clinical factors.

摘要

背景

本研究分析了肝肾移植受者的输血状况、趋势及其相关因素。

方法

通过国家健康保险服务数据库,确定了2008年至2017年间共10858例初次接受肝移植或肾移植的受者以及16191例初次接受肾移植的受者。记录输血的处方代码以及每种输血类型的存在情况、数量和总量。通过肝肾移植受者的特征确定比值比和95%置信区间,以识别输血和血液成分的显著差异。

结果

在本研究中,96.4%的肝移植受者和59.7%的肾移植受者接受了与移植手术相关的输血,主要是血小板和新鲜冰冻血浆。在肝移植和肾移植受者中均观察到女性围手术期输血率较高,且2008年至2017年输血率呈下降趋势。在肝移植受者中,接受 deceased 供体器官者的输血率远高于接受 living 供体器官者;然而,仅在 deceased 供体器官受者中,输血相关的死亡率较高。在肾移植受者中,接受输血者的死亡率高于未输血患者。

结论

在韩国,肝移植和肾移植受者的输血率相对高于其他国家。社会人口统计学因素,尤其是性别和移植年份,与实体器官受者的输血有关,可能是其他因果临床因素的替代指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a86/7697733/093c78f21591/jcm-09-03613-g001a.jpg

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