Double versus single renal allografts from aged donors
Double versus single renal allografts from aged donors
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DOI：
10.1097/00007890-200005270-00015
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发表时间：
2000-05-27
期刊：
影响因子：
6.2
通讯作者：
Leiva, O
中科院分区：
文献类型：
--
作者：
Andrés, A;Morales, JM;Leiva, O
背景。随着肾脏移植需求的不断增长，尸体肾脏供体的年龄限制也在不断提高。老年人肾脏同步双肾移植（SDKT）已被提出，以增加移植数量和改善其结果。然而，如果在没有明确适应症的情况下进行SDKT，则可能对移植患者的总数产生负面影响，因为两个肾脏将仅用于一个受体。材料和方法。1996年12月，我们设计了一项移植方案，以便能够扩大血清肌酐水平正常的尸体肾脏供体的选择范围，而不设任何年龄限制。无论供体年龄在60岁或以上，都要进行肾移植前活检以分析肾小球硬化（GE）百分比。当供体年龄在75岁或以上，或供体年龄在60 - 74岁之间，GE率超过15%时，对单个受者进行SDKT。相反，在两个不同的受者中对60 - 74岁供者的肾脏进行单肾移植，GE率低于15%。GE率超过50%的肾脏被丢弃用于移植。年龄小于60岁的供体肾脏通常用于单肾移植。根据上述方案，从1996年12月至1998年5月，我院共181例患者接受了肾移植，这些患者被分为三组：第一组包括SDKT受体（n=21），第二组或单肾受体来自60- 74岁的捐赠者（n=40），第三组或来自
Background. The age limit of the cadaver kidney donors is increasing in response to the growing demand for renal transplantation. Simultaneous double kidney transplantation (SDKT) with kidneys obtained from elderly adults has been proposed to increase the transplantation number and improve its results. However, if SDKT is performed when there are no clear indications, a negative effect could be produced on the total number of transplanted patients as both kidneys would be used for only one recipient.Material and Methods. In December 1996 we designed a transplantation protocol to be able to extend the selection of cadaver kidney donors with normal serum creatinine levels without establishing any age limit. A pregraft renal biopsy was always performed to analyze the glomerulosclerosis (GE) percentage whenever the donors were 60 gears of age or older. A SDKT was performed in a single recipient when the donor age was 75 years or older or when the donors between 60 and 74 years old had a GE rate of more than 15%. On the contrary, a single kidney transplantation was performed in two different recipients for kidneys from donors between 60 and 74 years of age with a GE rate of less than 15%. Kidneys having GE rates of more than 50% were discarded for transplantation. Donor kidneys from subjects younger than 60 years of age were always used for a single kidney transplantation.Results. Eased on the above mentioned protocol, from December 1996 to May 1998, 181 patients received a kidney transplantation in our hospital, These patients were divided into three groups: group I which included the SDKT recipients (n=21), group II or single kidney recipients from 60- to 74-year-old donors (n=40), and group III or recipients from