Magee J C, Sung R S, Turcotte J G, Punch J D, Ojo A O, Cibrik D M, Konnak J W, Bloom D A, Wolf J S, Kaplan B, Rudich S M, Bunchman T E, Leichtman A B, Merion R M, Campbell D A
University of Michigan Medical Center, Div of Transplantation, Ann Arbor, USA.
Clin Transpl. 1999:139-48.
The Michigan Kidney Transplant Program has existed for 35 years. Outcomes have improved dramatically as the one-year survival of cadaver kidney grafts increased from 25% to 85-90%. Patient deaths in the first year are now uncommon. Indications for renal transplantation have been extended to infants, the elderly, diabetics and to patients with other significant health problems who would not have been candidates in the past. Chronic administration of large doses of corticosteroids is no longer necessary and the associated morbidity is largely avoided. Improvements in immunosuppression, especially the introduction of cyclosporine, account for much of this progress. With success has come increasing demand. Unfortunately, the gap between the number of available donor kidneys and the number of patients listed for a cadaver transplant continues to increase rather than diminish. Greater acceptance of volunteer donation, as has occurred in our own program, will help to reduce this shortage. If the past forecasts the future, we can anticipate extraordinary advances during the next 35 years.
密歇根肾脏移植项目已经存在35年了。随着尸体肾移植的一年生存率从25%提高到85% - 90%，治疗效果有了显著改善。现在，患者在第一年死亡的情况已不常见。肾移植的适应证已扩大到婴儿、老年人、糖尿病患者以及过去不符合条件的其他有严重健康问题的患者。不再需要长期大剂量使用皮质类固醇，相关的发病率也基本得以避免。免疫抑制方面的改进，尤其是环孢素的引入，是取得这一进展的主要原因。随着成功而来的是需求不断增加。不幸的是，可用供体肾数量与尸体移植等待名单上的患者数量之间的差距仍在不断扩大，而非缩小。像我们自己的项目那样，更多地接受自愿捐赠将有助于缓解这种短缺。如果过去能预示未来，我们可以期待在未来35年取得非凡的进展。
