Impact of distance between donor and recipient hospitals on cadaveric kidney transplantation outcomes
Impact of distance between donor and recipient hospitals on cadaveric kidney transplantation outcomes
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供体与受援医院距离对尸体肾移植结局的影响
DOI：
10.1007/s10157-019-01710-z
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发表时间：
2019
影响因子：
2.3
通讯作者：
Ohyama Chikara
中科院分区：
文献类型：
--
作者：
Hamano Itsuto;Hatakeyama Shingo;Yamamoto Hayato;Fujita Takeshi;Murakami Reiichi;Shimada Michiko;Imai Atsushi;Yoneyama Tohru;Yoneyama Takahiro;Hashimoto Yasuhiro;Koie Takuya;Narumi Shunji;Saitoh Hisao;Suzuki Tadashi;Tomita Hirofumi;Ohyama Chikara
背景捐赠者和受者医院之间的距离对身体肾移植结果的影响尚不清楚。我们调查了日本医院间距离与身体肾移植结果的关系。方法回顾分析2002年至2017年日本363例身体肾移植病例。比较本院和日本国家移植队列的医院间距离、移植物运输时间、总缺血时间(TIT)和移植物存活率。对本院身体肾移植和活体供肾移植术后1个月和1年估计的肾小球滤过率(EGFR)进行比较。此外，还评估了日本7个地理区域之间的医院间距离。结果在我们医院和日本分别有12例和351例身体肾移植。医院间平均距离(217万 ± 1210公里)明显长于全国队列(53 ± 80万公里；P<； 0.001)。平均乳头和移植物存活率分别为539 ± 200min和91% ± 193min和81%。我们医院身体和活体供者移植后1年的平均eGFR相似(47 ± 16 vs.47 ± 15 mL/m in/1.73m~2)。日本七个地区之间的比较表明，医院间距离存在地区差异，面积(Km2)和医院间距离(Km)之间存在关联。结论尽管我们医院的医院间距离较长，但TIT和移植结果在我们的病例中是可以接受的。此外，还提出了日本在移植物分配方面的地域不平等问题。
BackgroundThe impact of distance between donor and recipient hospitals on outcomes in cadaveric kidney transplantations is unknown. We investigated the association between inter-hospital distance and outcomes in cadaveric kidney transplantations in Japan.MethodsWe retrospectively analyzed 363 cadaveric kidney transplantations between 2002 and 2017 in Japan. Inter-hospital distance, graft transport time, total ischemic time (TIT), and graft survival were compared between our hospital and national transplantation cohort in Japan. Estimated glomerular filtration rate (eGFR) 1 month and 1 year after transplantation was compared between cadaveric and living-donor kidney transplantations in our hospitals. Additionally, inter-hospital distances among the seven geographical regions in Japan were assessed.ResultsThere were 12 and 351 cadaveric kidney transplantations at our hospital and in Japan, respectively. Mean inter-hospital distance at our hospital (217 ± 121 km) was significantly longer than that of the national cohort (53 ± 80 km;P< 0.001). Mean TIT and graft survival for our hospital and national cohort were 539 ± 200 min and 91% and 491 ± 193 min and 81%, respectively. Mean eGFRs 1 year after cadaveric and living-donor transplantations at our hospitals were comparable (47 ± 16 vs. 47 ± 15 mL/min/1.73 m2). The comparison among seven regions in Japan indicated a regional difference in inter-hospital distance with an association between area (km2) and inter-hospital distance (km).ConclusionsDespite the longer inter-hospital distance at our hospital, TIT and transplant outcomes were acceptable in our cases. In addition, geographical inequity in graft allocation in Japan was suggested.