Comparison of survival probabilities for living-unrelated versus cadaveric renal transplant recipients
Comparison of survival probabilities for living-unrelated versus cadaveric renal transplant recipients
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DOI：
10.1016/j.transproceed.2004.08.122
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发表时间：
2004-09-01
影响因子：
0.9
通讯作者：
Lee, YD
中科院分区：
文献类型：
--
作者：
Park, YH;Min, SK;Lee, YD
由于用于移植的尸体来源日益短缺，任何改善器官捐赠的尝试都将是有益的。我们比较了非亲属活体供肾（LURD）和尸体供肾（CD）肾移植受者的移植物存活率和可能的预测变量。在1992年7月至2003年2月进行的104例连续肾移植中，41例来自利比里亚人和解与民主团结会，24例来自CD。免疫抑制方案以环孢霉素和类固醇为基础，1998年后加入吗替麦考酚酯。使用Kaplan-Meier方法估计患者和移植物存活率，并使用对数秩检验进行比较。采用考克斯比例风险模型分析预测变量的显著性水平。随访时间2 ~ 127个月，中位46个月。8例受体移植物丢失（6例来自LURD，2例来自CD），原因包括4例慢性排斥反应、1例急性排斥反应、1例原发病复发和1例功能正常的移植物死亡。LURD移植的1、3、5和7年移植物存活率分别为97.6%、91.9%、88.5%和82.2%，CD移植的分别为95.5%、90.9%、90.9%和90.9%（P > 0.05）。在LURD移植中，移植物功能延迟和供体年龄（> 55岁）是移植物存活的统计学显著预测因素。供者年龄（> 55岁）和术前多次输血史在CD移植中具有重要意义。LURD移植存活率与我们系列中CD移植相似。团结会是扩大器官捐献库的绝佳器官来源。
Any attempt to improve organ donation would be of benefit due to the growing shortage of cadaveric sources for transplantation.Objective. We compared the graft survivals and possible predictive variables among renal transplant recipients with organs from living unrelated (LURD) versus cadaveric donors (CD).Method. Among 104 consecutive renal transplants performed from July 1992 to February 2003, 41 were from LURD and 24 from CD. Immunosuppressive regimens were based on cyclosporine and steroids with mycophenolate mofetil added after 1998. Patient and graft survivals were estimated using the Kaplan-Meier method and compared using log-rank tests. The significance level of predictive variables was analyzed with the Cox proportional hazard model. The follow-up period was 2 to 127 months (median 46 months).Results. Eight recipients lost their grafts (six from LURD and two from CD) due to four chronic rejections, one acute rejection, one recurrence of primary disease, and one death with a functioning graft. The graft survival rates at 1, 3, 5, and 7 years were 97.6%, 91.9%, 88.5%, and 82.2% for LURD transplants versus 95.5%, 90.9%, 90.9%, and 90.9% for CD transplants, respectively (P > .05). Delayed graft function and donor age (> 55 years old) were statistically significant predictors of graft survival among LURD transplants. Donor age (> 55 years old) and multiple preoperative transfusion history were significant in CD transplants.Conclusion. LURD transplant survival was similar to that of CD transplants in our series. LURDs are an excellent source of organs to expand the donor pool.