Mange K C, Cherikh W S, Maghirang J, Bloom R D
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, USA.
N Engl J Med. 2001 Oct 25;345(17):1237-42. doi: 10.1056/NEJMoa010793.
The effect on allograft survival of the shipment of cadaveric renal allografts from one organ-procurement organization to another is uncertain.
Using data from the Organ Procurement and Transplantation Network of the United Network for Organ Sharing, we identified 5446 pairs of cadaveric kidneys (10,892 allografts) in which one kidney was shipped and the other was transplanted locally. We compared the risk of graft failure using statistical models that accounted for confounding variables, including the degree of HLA mismatching.
After adjustment for the degree of HLA mismatching, shipped organs had a significantly higher rate of allograft failure than locally transplanted organs in the first year after transplantation (adjusted hazard ratio, 1.17; 95 percent confidence interval, 1.05 to 1.31; P=0.004), but not thereafter. An association between the shipment of organs with no HLA mismatches and allograft failure was not confirmed.
The shipment of cadaveric renal allografts increases the risk of failure of HLA-mismatched grafts during the first year after transplantation.
尸体肾移植同种异体移植物从一个器官获取组织转运至另一个器官获取组织对移植物存活的影响尚不确定。
利用器官共享联合网络器官获取与移植网络的数据，我们确定了5446对尸体肾（10892个同种异体移植物），其中一个肾脏被转运，另一个在当地移植。我们使用统计模型比较了移植物失败的风险，该模型考虑了混杂变量，包括HLA错配程度。
在调整HLA错配程度后，转运的器官在移植后第一年的同种异体移植物失败率显著高于当地移植的器官（调整后的风险比，1.17；95%置信区间，1.05至1.31；P = 0.004），但之后则不然。未证实无HLA错配的器官转运与同种异体移植物失败之间存在关联。
尸体肾移植同种异体移植物的转运增加了移植后第一年HLA错配移植物失败的风险。
