Zhang R, Florman S, Devidoss S, Zarifian A, Yau C L, Paramesh A, Killackey M, Alper B, Fonseca V, Slakey D
Department of Medicine, Tulane University Health Sciences Center, New Orleans, LA, USA.
Am J Transplant. 2007 Jul;7(7):1815-21. doi: 10.1111/j.1600-6143.2007.01857.x. Epub 2007 May 25.
African Americans (AA) have traditionally been thought to have higher immunologic risk than Caucasians (CA) for rejection and allograft loss. The impact of ethnicity on the outcome of simultaneous pancreas-kidney (SPK) transplant with basiliximab induction has not been reported. In this study, we retrospectively analyze the long-term results of 36 AA and 55 CA recipients of primary SPK. The actual patient survival rates of AA and CA groups were 91.7% vs. 90.1% at 1 year, 93.3% vs. 88.1% at 3 years, and 94.4% vs. 83.3% at 5 years. The actual kidney survival of AA and CA were 91.7% vs. 89.1% at 1 year, 90% vs. 81% at 3 years, and 83.3% vs. 75% at 5 years. The actual pancreas survival of AA and CA were 88.9% vs. 85.5% at 1 year, 83.3% vs. 78.6% at 3 years and 72.2% vs. 70.8% at 5 years. Death-censored analyses also found no difference in pancreas and kidney graft survival rates over 5 years. Higher rejection rate, but the same low CMV infection, and comparable quality of graft function were noted in AA group. AA may not have worse long-term outcomes than CA recipients of SPK with basiliximab induction and tacrolimus (TAC), mycophenolate acid (MFA) and steroid maintenance immunotherapy.
传统观点认为，非裔美国人（AA）在移植排斥和移植器官丧失方面的免疫风险高于白种人（CA）。关于种族对巴利昔单抗诱导的同期胰肾联合移植（SPK）结果的影响，此前尚无报道。在本研究中，我们回顾性分析了36例接受初次SPK移植的AA患者和55例CA患者的长期结果。AA组和CA组的实际患者生存率在1年时分别为91.7%和90.1%，3年时分别为93.3%和88.1%，5年时分别为94.4%和83.3%。AA组和CA组的肾脏实际生存率在1年时分别为91.7%和89.1%，3年时分别为90%和81%，5年时分别为83.3%和75%。AA组和CA组的胰腺实际生存率在1年时分别为88.9%和85.5%，3年时分别为83.3%和78.6%，5年时分别为72.2%和70.8%。死亡截尾分析也发现，5年以上的胰腺和肾脏移植存活率没有差异。AA组的排斥率较高，但巨细胞病毒（CMV）感染率较低，且移植器官功能质量相当。在接受巴利昔单抗诱导、他克莫司（TAC）、霉酚酸（MFA）和类固醇维持免疫治疗的SPK移植中，AA患者的长期预后可能并不比CA患者差。
