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肝移植前口腔健康与肝移植后并发症之间的关联

Association Between Pre-Transplant Oral Health and Post-Liver Transplant Complications.

作者信息

Olander Annika Emilia, Helenius-Hietala Jaana, Nordin Arno, Savikko Johanna, Ruokonen Hellevi, Åberg Fredrik

机构信息

Department of Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Department of Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

出版信息

Transpl Int. 2023 Sep 12;36:11534. doi: 10.3389/ti.2023.11534. eCollection 2023.

Abstract

Oral disease is linked with systemic inflammation and various systemic conditions, including chronic liver disease. Liver transplantation (LT) candidates often need dental infection focus eradication, and after LT, there is high risk of many inflammation-related complications. We studied whether pre-LT dental status is associated with the occurrence of post-LT complications. This study included 225 adult LT recipients whose teeth were examined and treated before LT, and 40 adult LT recipients who did not have pre-LT dental data available. Data on post-LT complications were collected from the national liver transplant registry and followed up until the end of July 2020. Worse pre-LT dental status was associated with a higher risk of acute rejection post-LT compared to patients with good dental status. Worse dental status was also associated with higher 1-year-post-LT ALT levels and lower albumin levels. In conclusion, poor pre-LT oral health seems to associate with an increased risk of post-LT acute rejection and with elevated ALT levels and decreased albumin levels, suggesting an effect on post-LT liver health. Therefore, prevention and treatment of oral and dental diseases should be promoted early in the course of liver disease.

摘要

口腔疾病与全身炎症及各种全身性疾病相关,包括慢性肝病。肝移植(LT)候选者通常需要根除牙齿感染病灶,并且在肝移植后,存在许多炎症相关并发症的高风险。我们研究了肝移植前的口腔状况是否与肝移植后并发症的发生有关。本研究纳入了225例在肝移植前接受过牙齿检查和治疗的成年肝移植受者,以及40例没有肝移植前牙齿数据的成年肝移植受者。肝移植后并发症的数据从国家肝移植登记处收集,并随访至2020年7月底。与口腔状况良好的患者相比,肝移植前口腔状况较差与肝移植后急性排斥反应的较高风险相关。较差的口腔状况还与肝移植后1年较高的谷丙转氨酶(ALT)水平和较低的白蛋白水平相关。总之,肝移植前口腔健康状况不佳似乎与肝移植后急性排斥反应风险增加以及ALT水平升高和白蛋白水平降低有关,提示对肝移植后肝脏健康有影响。因此,应在肝病病程早期促进口腔和牙齿疾病的预防和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8c6/10520246/7dda3278ea70/TI_ti-2023-11534_wc_abs.jpg

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