Karakayali F, Moray G, Colak T, Boyvat F, Haberal M
Department of General Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
Transplant Proc. 2007 May;39(4):898-900. doi: 10.1016/j.transproceed.2007.02.051.
The shortage of cadaveric kidneys is growing in Turkey despite intensive efforts to find a solution. Living related donors are the primary source of kidneys in developing countries. When a first-degree relative of the patient is not available, a second-degree relative or a genetically unrelated but emotionally related donor, such as a spouse, becomes an alternative. From November 1985 to June 2006, 81 living unrelated kidney transplantations were performed between spouses at our hospital. Seventy-one of the donors were women, and 10 were men. The mean donor age was 33.9 +/- 8.5 years and the mean patient age was 38.5 +/- 8.8 years. The posttransplantation patient and graft survival rates were. 1 year: 93% patient survival, 83% graft survival; 3 years: 90% patient survival, 78% graft survival; and 5 years: 83% patient survival, 76% graft survival. During the posttransplantation period (mean, 82.5 +/- 61.4 months range, 6-216 months), seven patients died: three from sepsis, one from gastrointestinal hemorrhage, two from myocardial infarction, and one from pancreatitis. Three of those seven patients died with a functioning graft, and the seven other grafts were lost because of chronic rejection. To obstruct the underground trade in organs sold for transplantation, our center does not accept living unrelated organ donor candidates other than a spouse. Interspousal kidney transplantation is an important option with good clinical results. It provides the couple with a better quality of life, offers the opportunity to share the joy of giving, and enables a husband and wife to receive the "gift of life" from each other.
尽管土耳其为寻找解决方案付出了巨大努力，但尸体肾源短缺的问题仍在加剧。在发展中国家，亲属活体供肾是肾脏的主要来源。当患者的一级亲属无法提供供肾时，二级亲属或基因上无关联但情感上有关联的供体，如配偶，就成为了替代选择。1985年11月至2006年6月，我院共进行了81例配偶间非亲属活体肾移植手术。其中供体女性71例，男性10例。供体平均年龄为33.9±8.5岁，患者平均年龄为38.5±8.8岁。移植后患者和移植物的存活率如下：1年：患者存活率93%，移植物存活率83%；3年：患者存活率90%，移植物存活率78%；5年：患者存活率83%，移植物存活率76%。在移植后期间（平均82.5±61.4个月，范围6 - 216个月），7例患者死亡：3例死于败血症，1例死于胃肠道出血，2例死于心肌梗死，1例死于胰腺炎。这7例患者中有3例在移植物功能良好时死亡，另外7例移植物因慢性排斥反应而丢失。为了杜绝器官买卖的地下交易，我们中心不接受除配偶以外的非亲属活体器官供体候选人。配偶间肾移植是一种重要的选择，临床效果良好。它为夫妻双方提供了更高的生活质量，让他们有机会分享给予的喜悦，使夫妻能够从彼此那里获得“生命的礼物”。
