Frascà G M, Stefoni S
U.O. di Nefrologia, Dialisi e Trapianto Renale, Ospedale S.Orsola-Malpighi, Bologna, Italy.
G Ital Nefrol. 2003 Jul-Aug;20(4):400-13.
Recent advances in immunosuppressive therapy have dramatically reduced the incidence of acute rejection, thus improving graft survival. As a result, the importance of recurrence of the original nephropathy as a factor affecting the long-term outcome of the graft has grown considerably The incidence of recurrence increases with the increase in graft survival and can currently be estimated between 6 and 15% 10 years after surgery, with great variability among the different histological types of nephropathy. More than 50% of patients with recurrence experience progressive deterioration of graft function, and recurrence of the nephropathy accounts for long-term graft failure in more than 15% of cases. The original disease should be duly considered in all candidates for renal transplantation to identify patients at higher risk for recurrence and to define those treatment protocols devoted to risk reduction. Finally, the risk of disease recurrence should always be included among the parameters used in evaluating a possible transplantation from living donor.
免疫抑制治疗的最新进展显著降低了急性排斥反应的发生率，从而提高了移植物的存活率。因此，原发性肾病复发作为影响移植物长期预后的一个因素，其重要性已大大增加。复发率随移植物存活率的提高而增加，目前估计术后10年复发率在6%至15%之间，不同组织学类型的肾病之间差异很大。超过50%的复发患者经历移植物功能的进行性恶化，肾病复发在超过15%的病例中导致长期移植物失败。在所有肾移植候选者中，应适当考虑原发性疾病，以识别复发风险较高的患者，并确定旨在降低风险的治疗方案。最后，疾病复发的风险应始终纳入评估活体供体可能进行移植时所使用的参数之中。
