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来自无心跳供体的肾移植

Kidney transplantation from donors without a heartbeat.

作者信息

Weber Markus, Dindo Daniel, Demartines Nicholas, Ambühl Patrice M, Clavien Pierre-Alain

机构信息

Department of Visceral Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.

出版信息

N Engl J Med. 2002 Jul 25;347(4):248-55. doi: 10.1056/NEJMoa020274.

Abstract

BACKGROUND

The dramatic shortage of kidney donors has triggered interest in other sources of organs, such as donors without a heartbeat. Accumulating evidence suggests that the short-term survival of cadaveric kidneys from such donors is similar to that of cadaveric kidneys from donors with a heartbeat. However, no data from large, matched studies with long-term follow-up are available. We conducted a matched, single-center study of kidney transplants obtained from donors without a heartbeat and those from donors with a heartbeat, with a 15-year follow-up period.

METHODS

Between 1985 and 2000, 122 kidney transplantations involving donors without a heartbeat were performed at the University of Zurich, in Switzerland. Outcomes of these procedures were compared with those of 122 transplantations of kidneys from donors with a heartbeat. The recipients were matched according to age, sex, number of transplantations, and calendar period of transplantation.

RESULTS

The characteristics of the recipients did not differ significantly between the two groups. We observed a significantly higher incidence of delayed graft function among the patients who received kidneys from donors without a heartbeat (48.4 percent) than among the patients who received kidneys from donors with a heartbeat (23.8 percent) (P<0.001). However, the long-term rate of graft survival was similar in the two groups (P=0.98): at 10 years, the rate of graft survival was 78.7 percent for kidneys from donors without a heartbeat and 76.7 percent for kidneys from donors with a heartbeat.

CONCLUSIONS

Although the incidence of delayed graft function is significantly higher with kidneys from donors without a heartbeat than with kidneys from donors with a heartbeat, there is no difference in long-term outcome between the two types of graft.

摘要

背景

肾脏供体的严重短缺引发了人们对其他器官来源的兴趣,比如心跳停止的供体。越来越多的证据表明,来自此类供体的尸体肾脏的短期存活率与来自有心跳供体的尸体肾脏相似。然而,尚无来自大规模、配对且有长期随访的研究数据。我们进行了一项配对的单中心研究,对比了来自心跳停止供体的肾移植和来自有心跳供体的肾移植,并进行了15年的随访。

方法

1985年至2000年期间,瑞士苏黎世大学进行了122例涉及心跳停止供体的肾移植手术。将这些手术的结果与122例来自有心跳供体的肾移植结果进行比较。根据年龄、性别、移植次数和移植的日历时间对受者进行配对。

结果

两组受者的特征没有显著差异。我们观察到,接受心跳停止供体肾脏的患者中移植肾功能延迟的发生率(48.4%)显著高于接受有心跳供体肾脏的患者(23.8%)(P<0.001)。然而,两组的长期移植存活率相似(P=0.98):10年时,来自心跳停止供体的肾脏移植存活率为78.7%,来自有心跳供体的肾脏移植存活率为76.7%。

结论

尽管来自心跳停止供体的肾脏移植肾功能延迟的发生率显著高于来自有心跳供体的肾脏,但两种类型的移植长期结果并无差异。

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