Outcomes in kidney transplantation with mycophenolate mofetil-based maintenance immunosuppression in China: a large-sample retrospective analysis of a national database
Outcomes in kidney transplantation with mycophenolate mofetil-based maintenance immunosuppression in China: a large-sample retrospective analysis of a national database
复制标题
中国基于吗替麦考酚酯的维持免疫抑制肾移植的结果：国家数据库的大样本回顾性分析
DOI：
10.1111/tri.13566
复制
发表时间：
2020-01-12
影响因子：
3.1
通讯作者：
Wang, Yudi
中科院分区：
文献类型：
--
作者：
Chen, Liping;Bai, Hongwei;Wang, Yudi
目前尚无报告中国肾移植患者使用吗替麦考酚酯（MMF）结局的大型数据分析。本研究分析了来自中国肾移植科学登记中心的6719例使用MMF的患者，其中包括1153例心源性死亡（DCD）捐献者，1271例脑和心源性死亡（DBCD）捐献者和4295例活体供者（LD）。与死亡供体（DD）移植相比，（LD = 95.8% vs. DD = 91.3%），移植物功能延迟恢复的发生率（DGF，LD = 2.4% vs. DD = 17.7%），感染（LD = 10.7% vs. DD = 20.7%），移植物丢失（LD = 2.3% vs. DD = 6.3）和死亡LD组急性排斥反应发生率为1.3%，DD组为3.2%，两组急性排斥反应发生率相似AR（LD = 3.7% vs. DD = 4.7%）、术后1年内高尿酸血症（LD = 21.7% vs. DD = 22.2%）、1年时血清肌酐（Scr）>133 μ mol/l（LD = 18.8% vs. DD = 18.6%）。DCD组和DBCD组之间无显著差异。LD组患者和移植肾5年生存率分别为97.5%和93.0%。移植物丢失的校正考克斯模型显示与DGF [风险比3.7（95% CI：2.4，5.8）]、AR [2.8（1.7，4.6）]、1年时Scr >133 μ mol/l [2.6（1.5，4.2）]、高尿酸血症[2.3（1.6，3.3）]和DD [1.6（1.1，2.4）]显著相关。
There is no large data analysis reporting the outcome of Chinese kidney transplant patients using mycophenolate mofetil (MMF). This study analyzed 6719 patients from the Chinese Scientific Registry of Kidney Transplantation using MMF, which included 1153 from donation after cardiac death (DCD), 1271 from donation after brain and cardiac death (DBCD), and 4295 from living donor (LD). Compared with the transplants from deceased donor (DD), better outcomes including 3-year graft survival probabilities (LD = 95.8% vs. DD = 91.3%), incidence of delayed graft function (DGF, LD = 2.4% vs. DD = 17.7%), infection (LD = 10.7% vs. DD = 20.7%), graft loss (LD = 2.3% vs. DD = 6.3), and death (LD = 1.3% vs. DD = 3.2%) were shown in the LD group, with similar incidences of acute rejection (AR, LD = 3.7% vs. DD = 4.7%), hyperuricemia (LD = 21.7% vs. DD = 22.2%) within postoperative 1 year, and serum creatinine (Scr) >133 mu mol/l at 1 year (LD = 18.8% vs. DD = 18.6%). Nonsignificant differences were found between the DCD and DBCD group. The 5-year survival of patient and graft in the LD group were 97.5% and 93.0%. Adjusted Cox model for graft loss showed significant associations with DGF [hazard ratio 3.7 (95% CI: 2.4, 5.8)], AR [2.8 (1.7, 4.6)], Scr >133 mu mol/l at 1 year [2.6 (1.5, 4.2)], hyperuricemia [2.3 (1.6, 3.3)], and DD [1.6 (1.1, 2.4)].