Living Kidney Transplantation From Marginal Donors Presents Feasible Donor Renal Function Despite Inferior Recipient Renal Function
Living Kidney Transplantation From Marginal Donors Presents Feasible Donor Renal Function Despite Inferior Recipient Renal Function
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DOI：
10.1016/j.transproceed.2020.01.157
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发表时间：
2020-07-01
影响因子：
0.9
通讯作者：
Ohyama, Chikara
中科院分区：
文献类型：
--
作者：
Hamano, Itsuto;Hatakeyama, Shingo;Ohyama, Chikara
介绍。边缘供体肾移植是解决器官短缺问题的重要手段。在这项研究中，我们评估了我们医院边缘供者活体肾移植的安全性和有效性。2006年6月至2019年4月期间，107名患者在我们的医院接受了活体肾移植。边际捐赠者被定义为1。70岁，2岁。高血压、3。肌酐清除率30 kg/m(2)，或5。血红蛋白A1c >6.2%。我们回顾性比较了边缘供者和标准供者的肾功能及其时间变化。我们还比较了两组移植肾的存活率和受体肾功能。31名（29%）供体被定义为边缘供体。被定义为边缘的主要原因是高血压（74%）。边缘献血者的平均年龄（62 +/- 10岁）高于标准献血者（52 +/- 12岁，P < 0.001）。边缘组移植前后估计肾小球滤过率（eGFR）较低，而边缘组和标准组之间的eGFR下降率无差异。边缘供者的5年移植存活率（89%）并不明显低于标准供者（95%）。同时，从移植后1个月到5年，边际供者的受体eGFR低于标准供者。在供体eGFR下降率和移植物存活率方面，各组间无显著差异。因此，边际供体移植可能是解决供体短缺问题的可行方法。
Introduction. Kidney transplantation from marginal donors is an important solution for organ shortage problems. In this study, we evaluated the safety and effectiveness of living kidney transplantation from marginal donors at our hospitals.Methods. Between June 2006 and April 2019, 107 patients underwent living kidney transplantation at our hospitals. Marginal donors were defined as those with 1. age >70 years, 2. hypertension, 3. creatinine clearance 30 kg/m(2), or 5. hemoglobin A1c >6.2%. We retrospectively compared renal function and its chronological changes between marginal and standard donors. We also compared graft survival and recipient renal function between the groups.Results. Thirty-one (29%) donors were defined as marginal. The primary reason for being defined as marginal was hypertension (74%). The mean age of the marginal donors (62 +/- 10 years) was higher than that of standard donors (52 +/- 12 years, P < .001). The estimated glomerular filtration rate (eGFR) before and after transplantation was lower in the marginal group, whereas the decline ratio of eGFR was not different between the marginal and standard donors. Five-year graft survival of transplantations from marginal donors (89%) was not significantly inferior to that from standard donors (95%). Meanwhile, recipient eGFR was lower in transplantation from marginal donors than standard donors from 1 month through 5 years after transplantation.Conclusions. No significant differences were observed between the groups regarding the decline ratios of donor eGFR and graft survival. Thus, transplantation from marginal donors may be a feasible solution for donor shortage problems.