在美国成年人中，受者的功能状态会影响肠道移植的短期和长期结果。

Recipient functional status impacts on short and long-term intestinal transplant outcomes in United States adults.

作者信息

Boateng Sarpong, Ameyaw Prince, Gyabaah Solomon, Adjepong Yaw, Njei Basile

机构信息

Department of Medicine, Yale New Haven Health, Bridgeport Hospital, Bridgeport, CT 06610, United States.

Department of Epidemiology and Biostatistics, University of North Texas, Fort Worth, TX 76107, United States.

出版信息

World J Transplant. 2024 Sep 18;14(3):93561. doi: 10.5500/wjt.v14.i3.93561.

DOI:10.5500/wjt.v14.i3.93561

PMID:39295973

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11317861/

Abstract

BACKGROUND

Recipient functional status prior to transplantation has been found to impact post-transplant outcomes in heart, liver and kidney transplants. However, information on how functional status, before and after transplant impacts post-transplant survival outcomes is lacking.

AIM

To investigate the impact of recipient functional status on short and long term intestinal transplant outcomes in United States adults.

METHODS

We conducted a retrospective cohort study on 1254 adults who underwent first-time intestinal transplantation from 2005 to 2022. The primary outcome was mortality. Using the Karnofsky Performance Status, functional impairment was categorized as severe, moderate and normal. Analyses were conducted using Kaplan-Meier curves and multivariable Cox regression.

RESULTS

The median age was 41 years, majority (53.4%) were women. Severe impairment was present in 28.3% of recipients. The median survival time was 906.6 days. The median survival time was 1331 and 560 days for patients with normal and severe functional impairment respectively. Recipients with severe impairment had a 56% higher risk of mortality at one year [Hazard ratio (HR) = 1.56; 95%CI: 1.23-1.98; < 0.001] and 58% at five years (HR = 1.58; 95%CI: 1.24-2.00; < 0.001) compared to patients with no functional impairment. Recipients with worse functional status after transplant also had poor survival outcomes.

CONCLUSION

Pre- and post-transplant recipient functional status is an important prognostic indicator for short- and long-term intestinal transplant outcomes.

摘要

背景

已发现移植前受者的功能状态会影响心脏、肝脏和肾脏移植后的结局。然而，关于移植前后功能状态如何影响移植后生存结局的信息却很缺乏。

目的

研究美国成年人受者功能状态对小肠移植短期和长期结局的影响。

方法

我们对2005年至2022年期间接受首次小肠移植的1254名成年人进行了一项回顾性队列研究。主要结局是死亡率。使用卡氏功能状态评分，将功能损害分为严重、中度和正常。采用Kaplan-Meier曲线和多变量Cox回归进行分析。

结果

中位年龄为41岁，大多数（53.4%）为女性。28.3%的受者存在严重损害。中位生存时间为906.6天。功能正常和严重损害的患者中位生存时间分别为1331天和560天。与无功能损害的患者相比，严重损害的受者在1年时死亡风险高56%[风险比（HR）=1.56；95%置信区间：1.23-1.98；P<0.001]，在5年时高58%（HR=1.58；95%置信区间：1.24-2.00；P<0.001）。移植后功能状态较差的受者生存结局也较差。