LATE MORTALITY AND MORBIDITY IN RECIPIENTS OF LONG‐TERM RENAL ALLOGRAFTS
LATE MORTALITY AND MORBIDITY IN RECIPIENTS OF LONG‐TERM RENAL ALLOGRAFTS
复制标题
长期同种异体肾移植受者的晚期死亡率和发病率
DOI：
10.1097/00007890-198212000-00007
复制
发表时间：
1982
期刊：
影响因子：
6.2
通讯作者：
N. Tilney
中科院分区：
文献类型：
--
作者：
R. Kirkman;T. Strom;M. Weir;N. Tilney
本文回顾了彼得本特布里格姆医院217例移植肾功能恢复5年以上的经验。5年后患者和移植物存活率相似，10年和15年患者存活率分别为88%和66%，相同时间间隔的移植物存活率分别为85%和75%。15年时的移植物存活率高于患者存活率，因为功能正常的移植物死亡不被认为是移植物衰竭。活体亲属和尸体供体同种异体移植的患者或移植物存活率无差异。有33例死亡（15.2%），发生在移植后5/2至20/2年。慢性肝衰竭和败血症是最常见的死亡原因。32例患者（14.7%）在5年后失去了移植物，最常见的是慢性排斥反应。另有33例（15.2%）患者有慢性排斥反应、复发性肾小球肾炎、输尿管梗阻或肾动脉狭窄继发移植物功能障碍的证据。慢性排斥反应通常对免疫抑制药物的改变没有反应。不同严重程度的并发症很常见，影响了204例（94%）患者。最常见的是高血压、白内障、缺血性坏死、恶性肿瘤、尿路感染和肺炎。这些数据表明，移植相关的死亡率和发病率继续发生在长期肾移植受者。这些患者需要在有移植经验的医疗中心进行仔细和持续的护理。
The experience of the Peter Bent Brigham Hospital with 217 renal allografts functioning for more than 5 years is reviewed. Patient and graft survival were similar after 5 years, with patient survival being 88 and 66% at 10 and 15 years, respectively, and graft survival 85 and 75% at the same time intervals. Actuarial graft survival at 15 years was higher than patient survival because death with a functioning graft was not considered to be graft failure. No differences in patient or graft survival were found betwen living related and cadaver donor allografts. There were 33 deaths (15.2%), occurring from 5/2 to 20/2 years post-transplantation. Chronic liver failure and sepsis were the most common causes of death. Thirty-two patients (14.7%) lost their grafts after 5 years, most commonly from chronic rejection. Another 33 patients (15.2%) had evidence of graft dysfunction secondary to chronic rejection, recurrent glomerulonephritis, ureteral obstruction, or renal artery stenosis. Chronic rejection was generally not responsive to alterations in immunosuppressive medication. Complications of varying severity were common, affecting 204 (94%) of the patients. The most frequent were hypertension, cataracts, avascular necrosis, malignancy, urinary tract infection, and pneumonia. These data demonstrate that transplant-related mortality and morbidity continue to occur in recipients of long-term renal allografts. These patients require careful and continuing care in medical centers experienced in transplantation.