Cohen D J, St Martin L, Christensen L L, Bloom R D, Sung R S
Columbia University Medical Center, New York, NY, USA.
Am J Transplant. 2006;6(5 Pt 2):1153-69. doi: 10.1111/j.1600-6143.2006.01272.x.
This article examines OPTN/SRTR data on kidney and pancreas transplantation for 2004 and the previous decade, and discusses recent changes in kidney-pancreas (KP) allocation policy and emerging issues in kidney donation after cardiac death (DCD). Although the number of kidney donors continues to increase, new waiting list registrations again outpaced the number of kidney transplants performed, rising by 11% between 2003 and 2004 and contributing to a 1-year increase of 8% in the number of patients active on the waiting list. DCD has increased steadily since 2000; 39% more DCD transplants were performed in 2004 than 2003. Both deceased donor and living donor kidney graft survival rates remain excellent and are improving. The number of people living with a functioning kidney transplant doubled between 1995 and 2004, to 101,440 with a functioning kidney-alone and 7213 with a functioning KP. Health care providers in all settings are more likely to be exposed to these transplant recipients. Patient survival following simultaneous pancreas-kidney (SPK) transplantation is excellent and has improved incrementally since 1995; death rates in the first year fell from 60 per 1000 patient-years at risk in 2001 to 45 in 2003. The number of solitary pancreas transplants increased dramatically in 2004.
本文研究了器官共享联合网络（OPTN）/器官获取与移植受者科学注册系统（SRTR）关于2004年及此前十年的肾脏和胰腺移植数据，并讨论了肾胰联合移植（KP）分配政策的近期变化以及心脏死亡后器官捐献（DCD）中出现的问题。尽管肾脏捐献者数量持续增加，但新加入等待名单的人数再次超过了进行的肾脏移植数量，在2003年至2004年间增长了11%，导致等待名单上活跃患者数量一年增加了8%。自2000年以来，DCD稳步增加；2004年进行的DCD移植比2003年多39%。已故捐献者和活体捐献者的肾脏移植存活率仍然很高且在提高。1995年至2004年间，接受功能性肾脏移植的人数翻了一番，单独接受功能性肾脏移植的人数达到101,440人，接受功能性肾胰联合移植的人数为7213人。所有医疗机构的医护人员更有可能接触到这些移植受者。同期肾胰联合移植（SPK）后的患者存活率很高，自1995年以来逐步提高；第一年的死亡率从2001年每1000患者年风险60例降至2003年的45例。2004年单独胰腺移植的数量大幅增加。
