Callaghan Christopher J, Bradley J Andrew
University Department of Surgery, Addenbrooke's Hospital, Cambridge, England.
Methods Mol Biol. 2006;333:1-28. doi: 10.1385/1-59745-049-9:1.
Renal transplantation is the best treatment for most patients with end-stage renal failure. It markedly improves quality of life and in some cases increases life expectancy. Advances in immunosuppression and other areas of practice have led to an incremental improvement in outcome; 1- and 5-yr graft survival after cadaveric renal transplantation is now around 90 and 70%, respectively. This success has led to increased demand for transplantation that cannot be met by cadaveric heart-beating donors, numbers of which have remained relatively static. Increasing use is now being made of kidneys from so-called "marginal" or "extended criteria" cadaveric donors and from non-heart-beating donors. More reliance is also being placed on living kidney donation, which accounts for around 25% of kidney transplants in the United Kingdom and 50% of transplants in the United States. Much effort in renal transplantation is now being directed toward improving long-term outcomes. This chapter provides an overview of these and other issues in renal transplantation, focusing on some of the topics of current interest.
肾移植是大多数终末期肾衰竭患者的最佳治疗方法。它能显著提高生活质量，在某些情况下还能延长预期寿命。免疫抑制及其他实践领域的进展已使治疗效果逐步改善；目前，尸体肾移植术后1年和5年的移植物存活率分别约为90%和70%。这一成功导致对移植的需求增加，但脑死亡供体无法满足这一需求，其数量一直相对稳定。现在，所谓“边缘”或“扩大标准”尸体供体以及非心脏跳动供体的肾脏使用越来越多。活体肾捐赠也得到了更多依赖，在英国，活体肾捐赠约占肾移植的25%，在美国则占移植的50%。目前，肾移植的许多努力都致力于改善长期治疗效果。本章概述了肾移植中的这些及其他问题，重点关注当前一些热门话题。
