Long-term kidney transplant survival
Long-term kidney transplant survival
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DOI：
10.1053/ajkd.2001.28925
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发表时间：
2001-12-01
影响因子：
13.2
通讯作者：
Hariharan, S
中科院分区：
文献类型：
--
作者：
Hariharan, S
随着短期肾移植存活率的提高，重点已经转向长期存活。通过肾脏半衰期测量的长期存活率也有实质性改善。长期移植物衰竭继发于慢性移植物肾病（CAN）、疾病复发和移植物功能正常时的死亡。CAN继发于慢性排斥反应、慢性环孢素毒性和/或供体肾病的组合。慢性排斥反应的危险因素已被归因于免疫和非免疫原因。随着急性排斥反应率（CAN的一个重要风险因素）的显著降低，肾脏半衰期也有了实质性的改善。仍然有非免疫因素，如供体年龄，对移植物的长期存活有不利影响。此外，非洲裔美国人接受者的移植物半衰期仍然较短。复发性疾病正在成为晚期移植失败的一个重要原因。尽管引入了各种有效的免疫抑制剂，但对复发性疾病的患病率和进展几乎没有影响。随着急性排斥反应率的降低和移植物短期和长期存活率的提高，移植物长期存活率的进一步提高将是21世纪的重要焦点。(C)2001年由国家肾脏基金会，公司。
With improvements in short-term kidney graft survival, focus has shifted towards long-term survival. There has also been a substantial improvement in long-term survival as measured by kidney half-life. Long-term graft failure is secondary to chronic allograft nephropathy (CAN), recurrent disease, and death with a functioning graft. CAN is secondary to a combination of chronic rejection, chronic cyclosporine toxicity, and/or donor kidney disease. Risk factors for chronic rejection have been attributed to both immunological and nonimmunological causes. With a marked reduction in acute rejection rates-an important risk factor for CAN-there is a substantial improvement in kidney half-life. There are still nonimmunological factors, such as donor age, that adversely affect long-term graft survival. In addition, African-American recipients continue to have a shorter graft half-life. Recurrent disease is becoming an important cause of late graft failure. Despite the introduction of various potent immunosuppressive agents, there has been little or no impact on the prevalence as well as progression of recurrent diasease. With the reduction of acute rejection rates and improved short- and long-term graft survival, further improvements of long-term graft survival will be an important focus in the 21 st century. (C) 2001 by the National Kidney Foundation, Inc.