Deceased donor kidney transplantation in the United States from 1988 to 2011: an analysis of the OPTN/UNOS registry.
Deceased donor kidney transplantation in the United States from 1988 to 2011: an analysis of the OPTN/UNOS registry.
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发表时间：
2012
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通讯作者：
Dong Zhu;M. Everly
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作者：
Dong Zhu;M. Everly
在美国，从1988年到2011年，有超过170，000例第一次单独死亡供体肾移植报告给器官共享联合网络登记处。移植受者的构成随着时间的推移而发生变化。老年患者（31%至64.5%）、非高加索患者（36%至58%）、肥胖患者（体重指数超过35：11%至37%）、II型糖尿病患者（1%至28%）和高血压患者（17%至31%）的发生率显著增加。移植肾功能正常时的死亡是影响移植肾存活率的重要因素。死亡删失的移植肾存活率能更准确地反映危险因素与移植肾存活的关系。年轻患者，尤其是35岁以下的患者，移植物存活率更差。以糖尿病为原发病的患者，移植物存活率较差，但与大多数其他原发病相比，其影响并不明显。糖尿病（I型或II型）是患者死亡的主要原因。随着时间的推移，短期移植物存活率有明显的进步。移植物的长期存活仍然是一个问题。然而，从1993年到今天，存活超过1年的患者的5年死亡删失移植物存活率提高了7.9%。移植物功能延迟可能影响短期和长期移植物存活。人类白细胞抗原相容性是影响移植物存活的主要因素。零错配患者的20年死亡删失移植物存活率比有6个抗原错配的患者高18%。群体反应性抗体（PRA）也是影响移植物存活的重要因素。自2004年以来，已向联合国海洋观测系统报告了PRA I类和II类。与PRA I级相比，PRA II级与移植物存活率的相关性略高。
In the United States, over 170,000 first solitary deceased donor kidney transplants were reported to the United Network of Organ Sharing registry from 1988 to 2011. The composition of transplant recipients has changed over time. There were notable increases in older patients (31% to 64.5%), non-Caucasian patients (36% to 58%), obese patients (body mass index over 35: 11% to 37%), type II diabetes patients (1% to 28%), and patients with hypertension (17% to 31%). Death with functioning graft was a very important factor in analyzing kidney graft survival. The death-censored graft survival rate could more accurately reflect the relationships between risk factors and survival of kidney grafts. Younger patients, especially those younger than 35, had worse graft survival. Patients with diabetes as the primary disease showed poor graft survival, but the effect was not obvious compared to the majority of other primary diseases. Diabetes, either type I or type II, was a main contributor to patient death. There was notable progress in short-term graft survival over time. Long-term graft survival is still a problem. However, 5-year death-censored graft survival in patients who have survived longer than 1 year has improved by 7.9% from 1993 to today. Delayed graft function could impact both short- and long-term graft survival. Human leukocyte antigen compatibility was a main factor of graft survival. Zero mismatch patients have an 18% better 20-year death-censored graft survival than those with 6 antigen mismatches. Panel reactive antibody (PRA) is also an important factor to graft survival. PRA class I and class II has been reported to UNOS since 2004. PRA class II was slightly more related to graft survival compared to PRA class I.