Department of Surgery, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA.
Transplant Center, Queen's Medical Center, Honolulu, Hawaii, USA.
Clin Transplant. 2021 Jan;35(1):e14161. doi: 10.1111/ctr.14161. Epub 2020 Dec 6.
Frail patients who undergo renal transplantation (RT) have more complications; however, little is known if these patients can sustain the wait to RT. We used the Timed Up and Go Test (TUGT) and Montreal Cognitive Assessment (MoCA) to determine outcomes of RT candidates.
In this retrospective study, 526 RT candidates underwent TUGT and MoCA (2015-2019) and were divided into "favorable" (transplanted or remained on the list) or "unfavorable" (not listed, removed from list, or died) outcome. Demographics, education, language, comorbidities, dialysis type, use of a walking device, TUGT, and MoCA were compared by outcome.
Overall, 230 patients (43.7%) passed TUG, 268 (51%) passed MoCA, 133 (25.3%) passed both, and 161 (30.6%) failed both tests. Multivariate analysis demonstrated age ≥ 65 (OR 1.58, CI 1.03-2.43), cardiac disease (OR 3.09, CI 2.02-4.72), ≥36 months on dialysis (OR 1.80, CI 1.24-2.69), EPTS < 20% at time of MoCA (OR 0.26, CI 0.07-0.98), and failing TUGT (OR 2.14, CI 1.43-3.19) were associated with unfavorable outcome. Failing MoCA was not associated with outcome.
MoCA test results were not associated with RT waitlist outcomes; however, passing the TUGT was associated with receiving RT or remaining on the list. Additional studies are needed to validate this and determine outcome after RT.
接受肾移植 (RT) 的虚弱患者并发症更多；然而，尚不清楚这些患者是否能够等待 RT。我们使用计时起立行走测试 (TUGT) 和蒙特利尔认知评估 (MoCA) 来确定 RT 候选者的结果。
在这项回顾性研究中，526 名 RT 候选者接受了 TUGT 和 MoCA 测试（2015-2019 年），并分为“有利”（移植或留在名单上）或“不利”（未列入名单、从名单中删除或死亡）结果。通过结果比较人口统计学、教育、语言、合并症、透析类型、使用助行器、TUGT 和 MoCA。
总体而言，230 名患者（43.7%）通过了 TUG，268 名患者（51%）通过了 MoCA，133 名患者（25.3%）同时通过了这两项测试，161 名患者（30.6%）两项测试均未通过。多变量分析表明年龄≥65 岁（OR 1.58，CI 1.03-2.43）、心脏病（OR 3.09，CI 2.02-4.72）、透析时间≥36 个月（OR 1.80，CI 1.24-2.69）、MoCA 时 EPTS<20%（OR 0.26，CI 0.07-0.98）和 TUGT 失败（OR 2.14，CI 1.43-3.19）与不良结果相关。MoCA 测试结果与 RT 候补名单结果无关；然而，通过 TUGT 与接受 RT 或留在名单上相关。需要进一步的研究来验证这一点，并确定 RT 后的结果。
