Sesso R, Klag M J, Ancao M S, Whelton P K, Seidler A, Sigulem D, Ramos O L
Escola Paulista de Medicina, Division of Nephrology, Sao Paulo, Brazil.
Ann Intern Med. 1992 Dec 15;117(12):983-9. doi: 10.7326/0003-4819-117-12-983.
To compare patient and graft survival of recipients of kidneys from living, unrelated donors (LUDs); cadaveric donors; and living, related donors (LRDs) matched for zero (mismatched), one, or two (identical) haplotypes.
Cohort study.
Sixty-three renal transplantation centers affiliated with the Brazilian Transplantation Registry (accounting for more than 95% of the transplantation activity in Brazil).
Patients having renal transplantation between January 1987 and March 1991. Of 2892 patients, 165 (6%) received transplants from LUDs; 964 (33%), from cadaveric donors; 183 (6%), from zero haplotype, HLA-matched LRDs; 1259 (44%), from one haplotype-matched LRDs; and 321 (11%), from two haplotype-matched LRDs.
Patient and graft survival. Patients were followed for an average of 15.8 months.
After adjustment for age, race, diagnosis of primary disease, history of previous transplantation, cyclosporine use, and number of transplants from LUDs per center, patient survival did not differ statistically for recipients of kidneys from LUDs and recipients of cadaveric kidneys (risk ratio [RR], 1.16; 95% Cl, 0.68 to 1.98). Little difference was seen between the adjusted death rate for recipients of zero haplotype-matched LRDs and recipients of cadaveric kidneys (RR, 1.13; Cl, 0.69 to 1.87). Similarly, in a multivariate analysis, recipients of kidneys taken from LUDs and zero haplotype-matched LRDs had a risk for graft failure that did not differ statistically from that of cadaveric kidney recipients (RR, 0.74; Cl, 0.45 to 1.22 and RR, 0.82; Cl, 0.53 to 1.25, respectively).
Graft survival for recipients of kidneys from LUDs is similar to that from zero haplotype-matched LRDs and is at least as good as that achieved with cadaveric transplants.
比较接受来自活体非亲属供者（LUDs）、尸体供者以及零个（不匹配）、一个或两个（完全相同）单倍型匹配的活体亲属供者（LRDs）肾脏移植受者的患者和移植物存活率。
队列研究。
隶属于巴西移植登记处的63个肾移植中心（占巴西移植活动的95%以上）。
1987年1月至1991年3月期间接受肾移植的患者。在2892例患者中，165例（6%）接受了来自LUDs的移植；964例（33%）接受了来自尸体供者的移植；183例（6%）接受了零个单倍型匹配的HLA匹配LRDs的移植；1259例（44%）接受了一个单倍型匹配LRDs的移植；321例（11%）接受了两个单倍型匹配LRDs的移植。
患者和移植物存活率。对患者平均随访15.8个月。
在对年龄、种族、原发性疾病诊断、既往移植史、环孢素使用情况以及每个中心来自LUDs的移植数量进行调整后，接受LUDs肾脏移植受者和接受尸体肾脏移植受者的患者存活率在统计学上无差异（风险比[RR]，1.16；95%可信区间[Cl]，0.68至1.98）。零个单倍型匹配LRDs移植受者的校正死亡率与尸体肾脏移植受者之间差异不大（RR，1.13；Cl，0.69至1.87）。同样，在多变量分析中，接受LUDs肾脏移植受者和零个单倍型匹配LRDs移植受者的移植物失败风险与尸体肾脏移植受者相比在统计学上无差异（RR分别为0.74；Cl，0.45至1.22和RR，0.82；Cl，0.53至1.25）。
接受LUDs肾脏移植受者的移植物存活率与零个单倍型匹配LRDs移植受者相似，且至少与尸体移植的存活率一样好。
