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器官移植后的脂肪栓塞:对报告病例的系统评价

Fat embolism following organ transplantation: a systematic review of reported cases.

作者信息

Karimi Rozveh Javad, Abdi Hossein, Azizmanesh Mohammad, Chaghamirzayi Pouria

机构信息

Clinical Research Development Unit of Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran.

Department of Urology, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

Ann Med Surg (Lond). 2025 Apr 10;87(6):3748-3755. doi: 10.1097/MS9.0000000000003246. eCollection 2025 Jun.

Abstract

BACKGROUND

This systematic review consolidates reported cases of fat embolism following organ transplantation, analyzing patient demographics, donor characteristics, clinical features, diagnostic methods, management strategies, and outcomes.

METHODS

A systematic review following PRISMA guidelines was conducted across PubMed, Google Scholar, Cochrane, EMBASE, MEDLINE, and Scopus up to 31 August 2024. Case reports diagnosing fat embolism or fat embolism syndrome after organ transplantation in patients over 18 years were included. Data extraction was done using EndNote® X21.

RESULTS

Of the 889 studies identified, 13 met the inclusion criteria and encompassed data on 15 patients. The mean age of patients was 38.2 years, with 64.3% male. Lung transplants were the most common (60.0%), followed by liver and kidney transplants. The primary clinical features included respiratory distress (80.0%) and acute kidney injury (6.7%). The overall mortality rate was 53.3%, and supportive care was the primary treatment strategy.

DISCUSSION

This study highlights significant morbidity and mortality associated with fat embolism following organ transplantation. This review underscores the critical importance of early diagnosis, comprehensive donor screening, and the implementation of standardized management protocols. Further research is necessary to develop preventative strategies and improve patient outcomes in this rare but critical complication.

摘要

背景

本系统评价汇总了器官移植后脂肪栓塞的报告病例,分析了患者人口统计学、供体特征、临床特征、诊断方法、管理策略和结局。

方法

按照PRISMA指南,截至2024年8月31日,在PubMed、谷歌学术、Cochrane、EMBASE、MEDLINE和Scopus上进行了系统评价。纳入18岁以上器官移植后诊断为脂肪栓塞或脂肪栓塞综合征的病例报告。使用EndNote® X21进行数据提取。

结果

在识别出的889项研究中,13项符合纳入标准,涵盖了15例患者的数据。患者的平均年龄为38.2岁,男性占64.3%。肺移植最为常见(60.0%),其次是肝移植和肾移植。主要临床特征包括呼吸窘迫(80.0%)和急性肾损伤(6.7%)。总死亡率为53.3%,支持治疗是主要治疗策略。

讨论

本研究强调了器官移植后脂肪栓塞相关的显著发病率和死亡率。本评价强调了早期诊断、全面供体筛查以及实施标准化管理方案的至关重要性。有必要进一步开展研究以制定预防策略并改善这种罕见但严重并发症的患者结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad92/12140702/04fba533dafd/ms9-87-3748-g001.jpg

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