有关肾移植(KT)之前所需的牙齿清除预防移植后并发症的有效性的数据存在争议。这项回顾性研究的目的是调查任何未经治疗的口腔感染灶与KT患者全身并发症发作之间的可能相关性。
计划在移植后进行定期检查的患者在都灵的C.I.R.牙科学校就诊,意大利。要求患者携带移植前获得的骨科造影术(OPT),以比较移植时与移植后就诊时未经治疗的感染灶的可能存在。然后将患者分开,根据移植前获得的OPT评估,根据移植前的牙齿状况分为两组。“感染组”由没有牙齿清除的患者组成,和“组清除”包括牙齿清除的患者。然后对医疗记录进行回顾性审查,以评估移植后发生的任何全身性并发症。考虑了以下医学并发症:发烧,肺炎,尿路感染,全身性感染,肾排斥反应,和死亡。并发症分为两组:早期并发症,发生在移植后的100天内,和晚期并发症,发生在移植后100多天。
本研究共纳入77例患者。感染组由19名受试者(25%)组成,而Clear组由58名患者(75%)组成。在受感染的群体中,13例(68%)患者在移植后100天内出现并发症,11人(58%)在100天后这样做。在“组清除”中,31例(53%)患者在移植后100天内出现并发症,和23(40%)在100天后。感染组的患者发热发作有统计学上的显着增加(p=0.03),与GroupClear相比,在移植后的前100天,相对风险(RR)较高,为3.66。
在本回顾性试点研究的局限性内,根据结果,我们强调了KT之前没有牙齿清除与移植后前100天内出现发热的较高RR之间的相关性.目前的结果鼓励医生继续研究该主题,这仍然是有争议的。需要进一步的前瞻性研究来证实本研究的结果。
Data regarding the efficacy of the dental clearance required prior to kidney transplantation (KT) for preventing post-transplant complications is controversial. The aim of this retrospective study was to investigate a possible correlation between any untreated oral infectious foci and the onset of systemic complications in KT patients.
Patients scheduled for regular check-ups during the post-transplant period were visited at the C.I.R. Dental School in Turin, Italy. Patients were asked to bring orthopantomography (OPT) acquired prior to transplantation to compare the possible presence of untreated infectious foci at the time of transplantation with the time of their post-transplant visit. Patients were then divided, according to the evaluation of the OPT obtained prior to the transplantation, into two groups according to their dental status prior to the transplant. \"Group Infected\" was comprised of patients with no dental clearance, and \"Group Clear\" included patients with dental clearance. The medical records were then retrospectively reviewed for the evaluation of any systemic complications that occurred after transplantation. The following medical complications were considered: fever, pneumonia, urinary tract infections, systemic infections, kidney rejection, and death. Complications were divided in two groups: early complications, which occurred within 100 days of transplantation, and late complications, which occurred more than 100 days after transplantation.
A total of 77 patients were enrolled in the study. Group Infected was composed of 19 subjects (25%), while Group Clear was composed of 58 patients (75%). In Group Infected, 13 (68%) patients developed complications within 100 days of transplantation, and 11 (58%) did so after 100 days. In Group Clear, 31 (53%) patients had complications within 100 days of the transplant, and 23 (40%) did after 100 days. Patients in Group Infected had a statistically significant increase in episodes of fever (p = 0.03), compared to Group Clear, with a higher relative risk (RR) of 3.66 in the first 100 days after transplantation.
Within the limitations of the present retrospective pilot study, and based on the results, a correlation between the absence of dental clearance prior to KT and a higher RR of developing a fever within the first 100 days post transplantation was highlighted. The present results encourage doctors to continue research on the topic, which remains controversial. Further prospective studies are required to confirm the results of the present study.