Living donors >55 years: to use or not to use?
Living donors >55 years: to use or not to use?
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>55岁的活体捐赠者：使用还是不使用？
DOI：
10.1097/00007890-199904150-00011
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发表时间：
1999
期刊：
影响因子：
6.2
通讯作者：
Matas,AJ
中科院分区：
文献类型：
--
作者：
Kerr,SR;Gillingham,KJ;Johnson,EM;Matas,AJ
背景。使用老年捐赠者的肾脏移植越来越被接受为缓解日益严重的捐赠器官短缺的一种策略。迄今为止，大多数研究表明，与使用老年尸体供体移植物存活率下降，然而，活体供体年龄对移植物存活率的影响的研究是不太明确的。方法。我们研究了供体年龄对患者和移植物存活率的影响后，1126连续环孢素治疗的原发性肾移植1月1日，1985年12月31日，1995年。在这些移植物中，598个来自活体供体（74个来自> 55岁的供体），528个来自尸体供体（54个来自> 55岁的供体）。我们计算了活体供肾和尸体供肾受者的患者生存率、移植肾生存率和死亡删失的移植肾生存率。然后根据HLA错配（0 vs. 1-6）和是否存在急性排斥事件进一步划分活体供者。对活体和尸体供肾的受者进行了与移植物存活率降低相关因素的多变量分析。分析的因素包括供体年龄> 55岁，受体年龄> 50岁，糖尿病，HLA错配（0 vs. 1-6）和急性排斥反应。结果：对于尸体肾，单因素分析表明，总体（P= 0. 004）和死亡删失（P= 0. 001）移植肾存活率在年轻尸体肾中明显更好。我们的多变量分析支持这一点，该分析表明，尸体供体年龄> 55岁是精确移植物存活率差的独立预测因子（P= 0.0003）。
Background.Kidney transplants using older donors are becoming increasingly accepted as a strategy for alleviating the growing donor organ shortage. Most studies to date have shown decreased graft survival associated with the use of older cadaver donors; however, studies on the effect of living donor age on graft survival are less clear-cut.Methods.We studied the effect of donor age on patient and graft survival after 1126 consecutive cyclosporine-treated primary kidney transplants performed between January 1, 1985 and December 31, 1995. Of these grafts, 598 were from living donors (74 from donors> 55 years old) and 528 from cadaver donors (54 from donors> 55 years). We calculated actuarial patient survival, graft survival, and death-censored graft survival for recipients of both living donor and cadaver kidneys. Living donors were then further divided by HLA mismatch (0 vs. 1-6) and the presence or absence of an acute rejection episode. Multivariate analysis of factors associated with decreased graft survival was performed for recipients of both living and cadaver donor kidneys. Factors included for analysis were donor age> 55 years, recipient age> 50 years, the presence of diabetes mellitus, HLA mismatch (0 vs. 1-6), and the presence of an acute rejection episode.Results.For cadaver kidneys, univariate analysis indicates that both overall (P= 0.004) and death-censored (P= 0.001) graft survival was significantly better with younger cadaver kidneys. This is supported by our multivariate analysis, which shows that cadaver donor age> 55 years is an independent predictor of poor actuarial graft survival (P= 0.0003).
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移植老化的肾脏。
影响因子：
6.2
作者：
A. Matas;Simmons Rl;Kjellstrand Cm;Buselmeier Tj;Najarian Js
通讯作者：
Najarian Js
尸体供体年龄对移植后肾功能和移植结果的影响。
影响因子：
6.2
作者：
K. Rao;B. Kasiske;M. Odlund;A. Ney;R. Andersen
通讯作者：
R. Andersen
移植和老化的肾脏。
影响因子：
168.9
作者：
E. M. Darmady
通讯作者：
E. M. Darmady
肾移植结果的半衰期和危险因素——死亡与功能的重要性。
影响因子：
6.2
作者：
Matas,AJ;Gillingham,KJ;Sutherland,DE
通讯作者：
Sutherland,DE
序贯治疗——MALG 与 OKT3 对尸体肾同种异体移植受者进行预防性免疫抑制的前瞻性随机试验。
影响因子：
6.2
作者：
Frey,DJ;Matas,AJ;Gillingham,KJ;Canafax,D;Payne,WD;Dunn,DL;Sutherland,DE;Najarian,JS
通讯作者：
Najarian,JS