Chandrakantan Arun, de Mattos Angelo M, Naftel David, Crosswy Apryl, Kirklin James, Curtis John J
Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, THT 638B, 1530 Third Avenue South, Birmingham, AL 35294-0006, USA.
Clin J Am Soc Nephrol. 2006 Jul;1(4):832-6. doi: 10.2215/CJN.01191005. Epub 2006 Mar 29.
The use of cyclosporine and tacrolimus therapy in nonrenal (heart, heart/lung, lung, and liver) transplantation has resulted in improved patient and graft survival. Nephrotoxicity is one of the major side effects of tacrolimus and cyclosporine therapy and may lead to ESRD. The trend of referral of nonrenal solid-organ transplant recipients for kidney transplant evaluation at a large multiorgan transplant center was examined. Records of all patients who were referred for renal transplantation at the University of Alabama between January 1, 1993, and June 30, 2004, were reviewed. Eighty (0.96%) of 8318 individuals had previously undergone a nonrenal solid-organ transplant and were included in the study. The majority (72%) of patients had their nonrenal transplants performed at the University of Alabama. Twenty-two patients had their nonrenal transplant performed elsewhere and had fewer data available for analysis. From the period 1993-1996 to 2001-2004, an 11-fold increase in the absolute number of referrals of patients with nonrenal transplants was noted. Of patients who were referred for transplant evaluation, 25 became recipients of kidney transplants with a predominance of living-donor transplants. Referral for kidney transplant evaluation among nonrenal solid-organ transplant recipients is increasing and will exacerbate the existing shortage of deceased-donor kidneys that are available for transplantation. There was a trend for liver transplant recipients compared with other solid-organ recipients to develop ESRD at a greater rate.
环孢素和他克莫司疗法在非肾（心脏、心肺、肺和肝脏）移植中的应用已提高了患者和移植物的存活率。肾毒性是他克莫司和环孢素疗法的主要副作用之一，可能导致终末期肾病。我们研究了一家大型多器官移植中心将非肾实体器官移植受者转诊进行肾移植评估的趋势。回顾了1993年1月1日至2004年6月30日期间在阿拉巴马大学转诊进行肾移植的所有患者的记录。8318名个体中有80名（0.96%）先前接受过非肾实体器官移植，并被纳入研究。大多数患者（72%）在阿拉巴马大学进行了非肾移植。22名患者在其他地方进行了非肾移植，可供分析的数据较少。从1993 - 1996年到2001 - 2004年，非肾移植患者转诊的绝对数量增加了11倍。在转诊进行移植评估的患者中，25名成为肾移植受者，其中活体供体移植占主导。非肾实体器官移植受者中进行肾移植评估的转诊人数正在增加，这将加剧现有的可用于移植的 deceased - donor 肾脏短缺的情况。与其他实体器官受者相比，肝移植受者有以更高比例发展为终末期肾病的趋势。
