Outcome after renal transplantation in children from native and immigrant families in Austria
Outcome after renal transplantation in children from native and immigrant families in Austria
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DOI：
10.1007/s00431-008-0698-x
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发表时间：
2009-01-01
影响因子：
3.6
通讯作者：
Aufricht, Christoph
中科院分区：
文献类型：
--
作者：
Oztek, Fatma Zehra;Ipsiroglu, Osman;Aufricht, Christoph
肾移植是终末期肾病（ESRD）患儿的首选治疗方法。种族对移植存活率有很大影响，但欧洲学术界尚未对移民对儿童肾移植结局的影响进行评估。本研究的目的是比较奥地利维也纳医科大学儿科肾脏科的移民家庭儿童和本地家庭儿童的肾移植结果。我们对1997年1月至2005年6月在我中心接受肾移植的所有儿童进行了回顾性研究。根据移民背景将患者分为两组。在我们研究的时间范围内，59名儿童共接受了63次移植。在这些儿童中，42名来自奥地利本土，17名来自第一代移民家庭。我们分析了59例患者的人口统计学数据和结局参数。我们发现，本地和移民儿童之间的患者和移植物存活率或长期功能没有差异。两组在急性排斥反应发生率、24小时血压和生长速度方面也相当。活体供体来源对移植物功能（p=0.06），24小时血压（p=0.05）和生长速度（p=0.02）有积极的影响，只有在移民组。我们的回顾性分析显示，移民身份对患者或移植结果没有影响，但我们确实发现移民儿童比本地儿童从活体捐赠中受益更多，而不是死者捐赠。要解释这一事实，必须调查生物学、健康经济学、社会心理学和文化背景等方面。
Renal transplantation is the therapy of choice for children with end-stage renal disease (ESRD). Ethnicity affects the transplant survival rates substantially, but there has been no European academic evaluation of the effects of immigration on the pediatric renal transplantation outcome. The aim of this study was to compare the outcomes of renal transplantation between the children of immigrant families and the children of native families at the pediatric nephrology unit of the Medical University of Vienna, Austria. We conducted a retrospective study on all children who underwent renal transplantation at our center between January 1997 and June 2005. The patients were separated into two groups according to their immigration backgrounds. During the time frame of our study, 59 children underwent a total of 63 transplantations. Of these children, 42 were from native Austrian and 17 were from first-generation immigrant families. We analyzed the demographic data and outcome parameters for each of the 59 patients. We found no difference in patient and graft survival rates or long-term function between native and immigrant children. The two groups were also comparable in the rates of acute rejection episodes, 24-h blood pressure, and growth velocity. Living donor source had a positive influence on graft function (p=0.06), 24-h blood pressure (p=0.05), and growth velocity (p=0.02) only in the immigrant group. Our retrospective analysis shows no influence of the migration status on the patient or graft outcome, but we did find that immigrant children benefitted more than native children from living donation as opposed to deceased donation. To explain this fact, biological, heath-economical, psychosocial, and cultural background aspects must be investigated.