Schäffer M, Bartmann V, Wunsch A, Traska T, Schenker P, Michalski S, Viebahn R
Knappschaftskrankenhaus Bochum-Langendreer, Chirurgische Universitätsklinik, In der Schornau 23-25, 44892 Bochum, Deutschland.
Chirurg. 2007 Oct;78(10):928-35. doi: 10.1007/s00104-007-1362-0.
Differences in graft survival due to gender have been reported after transplantation of the kidney, liver, and heart. However, little is known about the role of donor and recipient gender in simultaneous pancreas-kidney transplantation.
Single-centre analysis was performed of first simultaneous pancreas-kidney transplantations performed between 1994 and 2005 at the Bochum Transplant Center in Germany (n=218).
Recipients of female donor organs exhibited acute organ rejections earlier and more frequently (P<0.05). Male recipients of organs from male donors had a lower risk of acute rejection than recipients of female donor organs (P<0.05). In addition to female donor gender, higher donor age and early kidney dysfunction were risk factors for perioperative rejection (P<0.05). Long-term kidney and pancreas function was best in male-donor-to-female-recipient transplants over the time periods of 7 and 3 years, respectively (P<0.05). Risk factors of long-term organ failure were: the need of revision laparotomy, organ rejection, and early postoperative organ dysfunction (P<0.05).
This is the first report of graft function after simultaneous pancreas-kidney transplantation looking specifically at gender differences with respect to donor and recipient. There was an increased risk of organ rejection of female donor organs.
肾、肝和心脏移植后,已有报道称移植物存活因性别而异。然而,关于供体和受体性别在胰肾联合移植中的作用,人们知之甚少。
对1994年至2005年在德国波鸿移植中心进行的首例胰肾联合移植进行单中心分析(n = 218)。
接受女性供体器官的受者急性器官排斥反应出现得更早且更频繁(P<0.05)。接受男性供体器官的男性受者发生急性排斥反应的风险低于接受女性供体器官的受者(P<0.05)。除女性供体性别外,供体年龄较大和早期肾功能不全是围手术期排斥反应的危险因素(P<0.05)。在7年和3年的时间段内,男性供体至女性受体的移植中,肾脏和胰腺的长期功能分别最佳(P<0.05)。长期器官衰竭的危险因素包括:需要进行剖腹手术修正、器官排斥反应和术后早期器官功能障碍(P<0.05)。
这是首例专门针对胰肾联合移植中供体和受体性别差异的移植物功能报告。女性供体器官的器官排斥反应风险增加。