Debska-Ślizień Alicja, Jankowska Magdalena M, Wołyniec Wojciech, Zietkiewicz Marcin, Gortowska Marzena, Moszkowska Grazyna, Chamienia Andrzej, Zadrozny Dariusz, Sledziński Zbigniew, Rutkowski Bolesław
Department of Nephrology, Gdańsk Medical University, Gdańsk, Debinki, Poland.
Transplantation. 2007 May 15;83(9):1188-92. doi: 10.1097/01.tp.0000260619.12790.a4.
Chronic renal failure is a disease of the elderly. The elderly are the fastest growing population among dialysis patients and also on waiting lists for kidney transplantation. The objective for this study was to analyze the results of the renal transplantation in recipients elder than 60 years. To minimize the donor variability and bias, a paired kidney analysis was used.
The older renal transplantation (ORT) group included 44 patients (30 men, 14 women) aged 60 to 72 (mean 64+/-3) years. Their pairs created a younger renal transplantation (YRT) group consisting of 44 patients (30 men, 14 women) aged 14 to 59 (mean 40+/-12) years.
Graft function estimated 1 year after transplantation applying abbreviated Modification of Diet in Renal Disease formula was significantly better in ORT (46.8+/-10.2 ml/min) versus YRT (43.7+/-16.8 ml/min). Studied groups (ORT vs. YRT) did not differ significantly with respect to 1-year patient survival (93.2% vs. 95.5%), 1-year graft survival (88.6% vs. 86.3%), 1-year death-censored graft survival (93% vs. 90.1%), and the incidences of delayed graft function and acute rejection. The most common complications noticed after ORT were cardiovascular complications, surgical complications, and infections.
Our single-center results confirm that renal transplantation is a good option of renal replacement therapy in patients older than 60 years. Thorough recipient selection and preparation as well as customized immunosuppressive protocols are particularly important in that group of renal transplant recipients.
慢性肾衰竭是一种老年疾病。老年人是透析患者中增长最快的群体，也是肾移植等待名单上增长最快的群体。本研究的目的是分析60岁以上受者肾移植的结果。为了尽量减少供体变异性和偏差，采用了配对肾脏分析。
老年肾移植（ORT）组包括44例患者（30例男性，14例女性），年龄在60至72岁（平均64±3岁）之间。他们的配对对象组成了一个年轻肾移植（YRT）组，包括44例患者（30例男性，14例女性），年龄在14至59岁（平均40±12岁）之间。
应用简化的肾脏疾病饮食改良公式评估移植后1年的移植物功能，ORT组（46.8±10.2 ml/min）明显优于YRT组（43.7±16.8 ml/min）。研究组（ORT组与YRT组）在1年患者生存率（93.2%对95.5%）、1年移植物生存率（88.6%对86.3%）、1年死亡审查移植物生存率（93%对90.1%）以及移植物功能延迟和急性排斥反应的发生率方面无显著差异。ORT后最常见的并发症是心血管并发症、手术并发症和感染。
我们单中心的结果证实，肾移植是60岁以上患者肾脏替代治疗的一个好选择。在该组肾移植受者中，全面的受者选择和准备以及定制的免疫抑制方案尤为重要。
