Living-donor and Deceased-donor Renal Transplantation: Differences in Early Outcome-A Single-center Experience
Living-donor and Deceased-donor Renal Transplantation: Differences in Early Outcome-A Single-center Experience
复制标题
DOI：
10.1016/j.transproceed.2015.03.008
复制
发表时间：
2015-05-01
影响因子：
0.9
通讯作者：
Casal, M.
中科院分区：
文献类型：
--
作者：
Guimaraes, J.;Araujo, A. M.;Casal, M.
活体供体肾移植（LDRT）比尸体供体肾移植（CDRT）产生更好的长期结果。本研究的目的是确定 LDRT 和 CDRT 接受者术后早期的差异。进行了一项回顾性研究，包括 2012 年和 2013 年在该中心接受 LDRT 和 CDRT 的所有患者。总共确定了 153 名接受者（CDRT n = 113，LDRT n = 40）。平均而言，LDRT 接受者平均年轻 12.7 岁 (P < .001)，并且合并症较少 (P < .05)。性别或原发性肾脏疾病没有差异。各组之间的平均透析时间、透析技术和缺血时间不同（分别为 P < .001、P < .01、P < .001）。 LDRT 接受者的平均住院时间缩短了 7 天 (P < .001)。我们发现早期并发症 (P < .001) 及其亚型的发生率存在显着差异，但神经系统和呼吸系统并发症除外。各组之间的再干预和再入院没有差异。受者年龄是总体术后并发症和感染并发症的独立危险因素；肾移植前高血压和冷缺血时间是心血管并发症的预测因素；冷缺血时间也是肾泌尿系统和内分泌并发症的预测因子。 CDRT患者住院期间术后并发症较多。对于两组患者来说，被确定为早期结果预测因素的变量是不同的。必须研究可改变的风险因素以获得更好的早期结果以及直接并发症对长期移植物存活的影响。
Living-donor renal transplant (LDRT) yields better long-term outcomes than cadaver-donor renal transplant (CDRT). The aim of the present study was to identify the differences in the early postoperative period between LDRT and CDRT recipients. A retrospective study was conducted including all patients receiving a LDRT and CDRT in this center in 2012 and 2013. A total of 153 recipients were identified (CDRT n = 113, LDRT n = 40). On average, LDRT recipients were younger by 12.7 years (P < .001) and had fewer comorbidities (P < .05). There were no differences in gender or primary kidney disease. Mean time on dialysis, dialytic technique, and ischemia time were different between groups (P < .001, P < .01, P < .001, respectively). On average the length of hospital stay for LDRT recipients was 7 days shorter (P < .001). We found significant differences in the occurrence of early complications (P < .001) and its subtypes, with the exception of neurologic and respiratory complications. There were no differences in reinterventions and readmissions between groups. Recipients' age was an independent risk factor for overall postoperative complications and infectious complications; hypertension before renal transplant and cold ischemia time were predictors for cardiovascular complications; and cold ischemia time also was a predictor of nephrourologic and endocrine complications. CDRT patients had more postoperative complications during hospital stay. The variables identified as predictors of early outcome were different for the 2 groups of patients. Modifiable risk factors for better early outcomes and the impact of immediate complications in long-term graft survival must be investigated.