Trasplante hepático en receptores sexagenarios: utilización de injertos de donantes con muerte circulatoria no controlada en comparación con injertos de donantes con muerte encefálica
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2021
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16/12/2020
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Universidad Complutense de Madrid
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Abstract
El envejecimiento conlleva un deterioro funcional y una mayor vulnerabilidad ante cualquier cirugía. Sin embargo, la mejora de la calidad de vida de la población envejecida y la continua progresión en los resultados obtenidos con la cirugía han conseguido priorizar el estado funcional por encima de la edad. En el trasplante hepático (TH) se han ampliado las indicaciones a los grupos de mayor edad, con buenos resultados en términos de supervivencia. Sin embargo, el aumento en la demanda y la elevada mortalidad en lista de espera, requieren la búsqueda de nuevas fuentes de donación, con los llamados donantes con criterios extendidos, como los donantes en muerte circulatoria no controlada (DMCnc), en los que se asumen mayores complicaciones biliares (CB) como la colangiopatía isquémica (CI) y el fallo primario del injerto (FPI).En este escenario, es necesario optimizar recursos mediante una adecuada selección de pacientes e injertos...
Aging leads to functional deterioration and to a greater vulnerability to any surgery. However, the improvement in the quality of life of the elder population and the continuous progression in the results obtained with surgery have managed to prioritize functional status over age.In liver transplantation (LT), the indications have been extended to elder age groups, with good results in terms of survival. However, the increase in demand and the high mortality on the waiting list require the search for new donation sources, with so-called extended criteria donors, such as donors from uncontrolled circulatory death (uDCD), in which greater biliary complications (BC) such as ischemic cholangiopathy (IC) and primary graft failure (PGF) are assumed. In this scenario, it is necessary to optimize resources through an adequateselection of patients and grafts...
Aging leads to functional deterioration and to a greater vulnerability to any surgery. However, the improvement in the quality of life of the elder population and the continuous progression in the results obtained with surgery have managed to prioritize functional status over age.In liver transplantation (LT), the indications have been extended to elder age groups, with good results in terms of survival. However, the increase in demand and the high mortality on the waiting list require the search for new donation sources, with so-called extended criteria donors, such as donors from uncontrolled circulatory death (uDCD), in which greater biliary complications (BC) such as ischemic cholangiopathy (IC) and primary graft failure (PGF) are assumed. In this scenario, it is necessary to optimize resources through an adequateselection of patients and grafts...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, leída el 16/12/2020