Influence of cadaver donor age on posttransplant renal function and graft outcome.
Influence of cadaver donor age on posttransplant renal function and graft outcome.
复制标题
尸体供体年龄对移植后肾功能和移植结果的影响。
DOI：
10.1097/00007890-199001000-00020
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发表时间：
1990
期刊：
影响因子：
6.2
通讯作者：
R. Andersen
中科院分区：
文献类型：
--
作者：
K. Rao;B. Kasiske;M. Odlund;A. Ney;R. Andersen
为了评估尸体供体年龄对移植后肾功能和移植物存活的影响，我们分析了 17 名年轻供肾受者（小于 10 岁）和 48 名老年供肾受者（大于 50 岁）的临床结果，并将其与接受 11 至 50 岁供肾的 598 名患者组成的对照组进行比较。这 3 组在受者年龄、透析持续时间、既往输血、既往移植、冷缺血时间、HLA AB 不匹配、细胞毒性抗体谱、移植后 ATN 和预防性 ALG 治疗方面具有可比性。 3 组中 1 年、2 年和 3 年的累积患者生存率没有显着差异，但老年供肾受者的移植物生存率显着低于对照组（2 年时为 71% 与 62%，P = .09，3 年时为 66% 与 55%，P = .0003。移植后 1 个月评估的短期肾功能明显低于对照组） （肌酐清除率 45 mL/min vs. 59 mL/min，P = .0003）同样，老年供体组在最后一次随访时评估的长期肾功能也低于对照组（肌酐清除率 40 mL/min vs. 49 mL/min，P = .07）。年轻供体组和对照组之间的移植物存活率或短期或长期肾功能没有显着差异。来自老年尸体捐献者的肾脏与移植后效果较差有关，是否使用老年捐献者肾脏的实际决定应考虑到这一点以及其他因素。
To assess the impact of cadaver donor age on posttransplant renal function and graft survival, we analyzed our clinical results in 17 recipients of younger donor kidneys (less than 10 years) and 48 recipients of older donor kidneys (greater than 50 years) and compared them with a control group of 598 patients who received kidneys from donors between 11 and 50 years of age. The 3 groups were comparable with respect to recipient age, duration of dialysis, prior transfusions, previous transplants, cold ischemia time, HLA AB mismatches, cytotoxic antibody profile, posttransplant ATN, and prophylactic ALG treatment. The cumulative patient survival at 1, 2, and 3 years was not significantly different among the 3 groups, but the graft survival in recipients of older donor kidneys was significantly lower than the control (71% vs. 62% at 2 years, P = .09 and 66% vs. 55% at 3 years, P = .0003. The short-term renal function assessed at 1 month posttransplant was significantly lower in the older donor group compared with the control (creatinine clearance 45 mL/min vs. 59 mL/min, P = .0003). Likewise, the long-term renal function assessed at the last follow-up was also lower in the older donor group than the control (creatinine clearance 40 mL/min vs. 49 mL/min, P = .07). There were no significant differences in graft survival or short- or long-term renal function between the younger donor group and the control group. These observations suggest that transplantation of a kidney from an older cadaver donor is associated with an inferior posttransplant outcome. The practical decision whether or not to use an older donor kidney should be individualized taking this as well as other factors into account.