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肝移植后的衰弱:一个复杂的未被探索的问题。

Frailty after Liver Transplantation: A Complex Unexplored Issue.

作者信息

Gabrielli Filippo, Biagi Filippo, Avossa Alessandra, Falcini Margherita, Nascimbeni Fabio, Andreone Pietro, Gitto Stefano

机构信息

Internal and Metabolic Medicine, Department of Medical and Surgical Sciences for Children & Adults, AOU of Modena, University of Modena and Reggio Emilia, 41126 Modena, Italy.

Department of Surgical Sciences, University of Bologna, 40126 Bologna, Italy.

出版信息

J Clin Med. 2024 Aug 2;13(15):4537. doi: 10.3390/jcm13154537.

Abstract

Frailty is a multidimensional syndrome predominantly studied in the elderly, characterized by reduced resistance to stressors due to diminished physiological reserve and resilience. Advances in surgical techniques and immunosuppressive drugs have improved long-term survival rates in solid organ transplant recipients, yet the 10-year survival is satisfying. However, liver transplant recipients have a noteworthy risk of developing frailty status. After liver transplant, frailty can be favored by socioeconomic, cultural, and health-related factors, leading to increased risks of hospitalization, morbidity, and mortality. Various tools for frailty assessment exist, but none are universally validated for post-transplant patients. The integration of socioeconomic and psychological factors into frailty evaluation could improve quality of life and long-term outcomes for transplant recipients. Multidisciplinary approaches, including psychosocial support, are essential for managing frailty and enhancing the overall care of transplanted patients. This narrative review aims to comprehensively address the principal frailty risk factors associated with liver transplantation.

摘要

衰弱是一种主要在老年人中研究的多维综合征,其特征是由于生理储备和恢复力下降而导致对应激源的抵抗力降低。手术技术和免疫抑制药物的进步提高了实体器官移植受者的长期生存率,但10年生存率并不理想。然而,肝移植受者有发生衰弱状态的显著风险。肝移植后,社会经济、文化和健康相关因素可能导致衰弱,从而增加住院、发病和死亡风险。虽然存在多种衰弱评估工具,但没有一种在移植后患者中得到普遍验证。将社会经济和心理因素纳入衰弱评估可以改善移植受者的生活质量和长期预后。包括心理社会支持在内的多学科方法对于管理衰弱和加强移植患者的整体护理至关重要。本叙述性综述旨在全面阐述与肝移植相关的主要衰弱风险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6aeb/11313396/91aec1bc6f57/jcm-13-04537-g001.jpg

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