Transplantation of A2 Kidneys into B and O Recipients Leads to Reduction in Waiting Time: USRDS Experience
Transplantation of A2 Kidneys into B and O Recipients Leads to Reduction in Waiting Time: USRDS Experience
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DOI：
10.1097/tp.0b013e3181da191a
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发表时间：
2010-06-15
期刊：
影响因子：
6.2
通讯作者：
Jindal, Rahul M.
中科院分区：
文献类型：
--
作者：
Hurst, Frank P.;Sajjad, Imran;Jindal, Rahul M.
导论.将来自A2供体的肾移植到具有血型B和O受体的患者中的策略已被用于减轻长的等待时间。我们使用了美国肾脏数据系统数据库中的一个初始队列，患者年龄大于18岁，在1995年1月至2006年7月期间接受了肾移植。主要结局变量为同种异体移植物丢失（包括死亡）。对与接受A2或A2 B肾脏相关的因素进行双变量分析，分类变量采用卡方检验（Fisher精确检验用于违反Cochran假设），连续变量采用Student t检验（Mann-Whitney U检验用于非正态分布变量）。首次肾移植150,118例，其中A2 ~ O肾移植113例，A2 ~ B肾移植125例。与来自同一血型的其他受体相比，A2肾的受体等待时间明显缩短。O型受体的中位等待时间为1.63年（范围0.00-17.21年），而接受A2肾的O型受体的中位等待时间为0.70年（范围0.02-1.47年; P < 0.001）。B受体的中位等待时间为1.90年（范围0.00-17.52年），而接受A2肾的B受体的中位等待时间为0.74年（范围0.10-5.21年; P < 0.001）。A2 ~ O组和B组移植物丢失或死亡率与其他各组比较无显著性差异。结果显示，接受A2至B或O型肾移植的患者相对较少。
Introduction. Strategy of transplanting kidneys from A2 donors into patients with blood group B and O recipients has been used to alleviate the long waiting times.Materials and Methods. We used an inception cohort of US Renal Data System data base with patients older than 18 years who underwent renal transplantation between January 1995 and July 2006. The primary outcome variable was allograft loss (including death). Bivariate analysis of factors associated with receiving A2 or A2B kidneys was performed with chi-square testing for categorical variables (Fisher's exact test used for violations of Cochran's assumptions) and Student's t test for continuous variables (Mann-Whitney U test used for nonnormally distributed variables).Results. There were 150,118 first kidney transplants of whom 113 received kidney transplant from A2 to O, and 125 patients received A2 to B kidney transplant. Compared with other recipients from the same blood group, recipients of A2 kidneys had significantly shorter wait times. O recipients had a median wait time of 1.63 years (range 0.00-17.21 years), whereas O recipients who received A2 kidneys had a median wait time of 0.70 years (range 0.02-1.47 years; P < 0.001). B recipients had a median wait time of 1.90 years (range 0.00-17.52 years), whereas B recipients who received A2 kidneys had a median wait time of 0.74 years (range 0.10-5.21 years; P < 0.001). There was no significant difference in graft loss or death between A2 to O and B versus all other recipients.Conclusions. The results showed that comparatively few patients received A2 to B or O kidney transplant.