Kidney transplantation in elderly people: the influence of recipient comorbidity and living kidney donors.
Kidney transplantation in elderly people: the influence of recipient comorbidity and living kidney donors.
复制标题
老年人肾移植：受者合并症和活体肾捐赠者的影响。
DOI：
10.1111/j.1532-5415.2007.01542.x
复制
发表时间：
2008
影响因子：
6.3
通讯作者：
Unruh,Mark
中科院分区：
文献类型：
--
作者：
Wu,Christine;Shapiro,Ron;Tan,Henkie;Basu,Amit;Smetanka,Cynthia;Morgan,Claire;Shah,Nirav;McCauley,Jerry;Unruh,Mark
目的：研究供者和受者的特征与老年肾移植患者移植结果的关系。设计：回顾性研究。设置：单一大学中心。研究对象：1,102名患者，包括66名60岁及以上的患者。测量：受者和供者的特征以及患者和移植物的结果。结果：在纳入研究的1,102名患者中，266名(25%)年龄在60岁及以上，117名(11%)年龄在67岁及以上。根据Cox比例风险分析，尽管年龄最大的受者组(68-86岁)的生存结果与稍年轻的同龄人(61-67岁)相当，但老年受者的患者生存较差。移植物功能并不因年龄而异。在老年肾移植受者中，合并症是患者存活的重要预测因素(风险比(HR)=1.17，95%可信区间(CI)=1.03-1.34，P=0.02)，但在接受活体肾脏的老年受者中(HR=1.01，95%CI=0.8-1.3，P=0.9)，合并症是患者存活的重要预测因素。结论：老年人肾移植可以取得良好的效果，尽管在有严重并发症的受者中，谨慎的供者选择和选择活体供者可能是获得良好结果的关键。
OBJECTIVES:To examine the extent to which donor and recipient characteristics were associated with transplant outcomes in elderly kidney transplant recipients.DESIGN:Retrospective review.SETTING:Single university center.PARTICIPANTS:One thousand one hundred two patients, including 266 patients aged 60 and older.MEASUREMENTS:Recipient and donor characteristics and patient and graft outcomes.RESULTS:Of the 1,102 patients included in this study, 266 (25%) were aged 60 and older, and 117 (11%) were aged 67 and older. According to Cox proportional hazards analysis, patient survival was worse in elderly recipients, although the survival outcome in the oldest group (ages 68–86) was comparable with that in their slightly younger peers (ages 61–67). Graft function did not differ according to age. Comorbidity was a significant predictor of patient survival in elderly recipients (hazard ratio (HR)=1.17, 95% confidence interval (CI)=1.03–1.34,P=.02) but not in the subset of elderly recipients of living donor kidneys (HR=1.01, 95% CI=0.8–1.3,P=.9).CONCLUSION:Older adults can achieve good outcomes with kidney transplantation, although in recipients with significant comorbid illness, careful donor selection and selective use of living donors may be vital to achieving good outcomes.