Survival Benefit with Kidney Transplants from HLA-Incompatible Live Donors
Survival Benefit with Kidney Transplants from HLA-Incompatible Live Donors
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DOI：
10.1056/nejmoa1508380
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发表时间：
2016-03-10
影响因子：
158.5
通讯作者：
Segev, D. L.
中科院分区：
文献类型：
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作者：
Orandi, B. J.;Luo, X.;Segev, D. L.
背景来自一个大容量单一中心的报告表明，无论是否接受来自已故捐赠者的肾脏，与留在等待名单上相比，接受来自 HLA 不相容的活体捐赠者的肾脏移植具有生存益处。这一发现的普遍性尚不清楚。 方法在一项 22 中心研究中，我们估计了 1025 名 HLA 不相容活体捐献者肾移植受者的生存获益，这些受者与仍在等待名单上或接受已故捐献者移植的对照（等待名单或移植对照组）和仍在等待名单上但未接受移植的对照（仅等待名单对照组）相匹配。我们分析了研究中包含和不包含来自数量最多的中心的患者的数据。结果来自不相容活体捐献者的肾移植受者在 1 年时的存活率高于任一对照组（95.0%，对比等待名单或移植对照组的 94.0%，仅等待名单对照组的 89.6%）、3 年（91.7% 对比 83.6% 和 72.7%，分别）、5 年（86.0% vs. 74.4% 和 59.2%）和 8 年（76.5% vs. 62.9% 和 43.9%）（P
BACKGROUNDA report from a high-volume single center indicated a survival benefit of receiving a kidney transplant from an HLA-incompatible live donor as compared with remaining on the waiting list, whether or not a kidney from a deceased donor was received. The generalizability of that finding is unclear.METHODSIn a 22-center study, we estimated the survival benefit for 1025 recipients of kidney transplants from HLA-incompatible live donors who were matched with controls who remained on the waiting list or received a transplant from a deceased donor (waitinglist-or-transplant control group) and controls who remained on the waiting list but did not receive a transplant (waiting-list-only control group). We analyzed the data with and without patients from the highest-volume center in the study.RESULTSRecipients of kidney transplants from incompatible live donors had a higher survival rate than either control group at 1 year (95.0%, vs. 94.0% for the waiting-list-ortransplant control group and 89.6% for the waiting-list-only control group), 3 years (91.7% vs. 83.6% and 72.7%, respectively), 5 years (86.0% vs. 74.4% and 59.2%), and 8 years (76.5% vs. 62.9% and 43.9%) (P