Einollahi B, Pourfarziani V, Ahmadzad-Asl M, Davoudi F, Lessan-Pezeshki M, Davoudi A, Nourbala A, Shariat-Moghani S, Nemati E, Poor-Reza-Gholi F F, Simforoosh N
Nephrology and Urology Research Center, and Department of Internal Medicine, Baqyiatallah University of Medical Sciences, Tehran, Iran.
Transplant Proc. 2007 May;39(4):907-10. doi: 10.1016/j.transproceed.2007.03.033.
Considering the organ shortage crisis for renal transplantation worldwide, assessing the risk factors to establish better allocation strategies to improve graft survival seems to be crucial.
We aimed to evaluate the risk factors influencing graft and patient survival after renal transplantation to construct a model of prognostic factors for living renal transplantation (LRT), namely living unrelated renal transplantation (LURT).
We designed a retrospective multicenter survey including medical record review of 3028 patients who received renal transplants at 2 hospitals between July 1984 and December 2005. We assessed the impact on graft survival of recipient/donor relationship, recipient age and gender, donor age and gender, and viral hepatitis B and C infections.
Among 3028 recipients, including 94.8% primary grafts, 63.4% were men, mean +/- SE of age 36.4 +/- 0.3 years, with mostly end-stage renal disease due to diabetes mellitus, hypertension, or glomerulonephritis. One-, 5-, 10- and 15-year graft survival rates were 85.4%, 68.3%, 46.4%, and 23.8%, respectively. Patient survival rates were 93.4%, 87.5%, 79.4%, and 66.4% at the above intervals, respectively. Donor age (relative hazard [RH], 1.024; P<.001), unrelated donors (RH, 1.7; P<.001), and hepatitis C virus (HCV) infection (RH, 2.65; P<.001) were the only significant factors affecting graft survival.
Increased donor age, unrelated donor, and HCV infection were significant factors negatively impacting graft survival; thus, proper management of these factors may lead to better graft and patient survival.
考虑到全球肾移植面临的器官短缺危机，评估风险因素以制定更好的分配策略来提高移植物存活率似乎至关重要。
我们旨在评估肾移植后影响移植物和患者存活的风险因素，以构建活体肾移植（LRT），即活体非亲属肾移植（LURT）的预后因素模型。
我们设计了一项回顾性多中心调查，包括对1984年7月至2005年12月期间在两家医院接受肾移植的3028例患者的病历进行审查。我们评估了受者/供者关系、受者年龄和性别、供者年龄和性别以及乙型和丙型病毒性肝炎感染对移植物存活的影响。
在3028例受者中，包括94.8%的初次移植物，63.4%为男性，平均年龄±标准差为36.4±0.3岁，大多数为终末期肾病，病因是糖尿病、高血压或肾小球肾炎。1年、5年、10年和15年的移植物存活率分别为85.4%、68.3%、46.4%和23.8%。在上述时间段内，患者存活率分别为93.4%、87.5%、79.4%和66.4%。供者年龄（相对危险度[RH]，1.024；P<0.001）、非亲属供者（RH，1.7；P<0.001）和丙型肝炎病毒（HCV）感染（RH，2.65；P<0.001）是影响移植物存活的仅有的显著因素。
供者年龄增加、非亲属供者和HCV感染是对移植物存活有负面影响的显著因素；因此，对这些因素进行适当管理可能会提高移植物和患者的存活率。
