Ushigome H, Sakai K, Suzuki T, Nobori S, Yoshizawa A, Akioka K, Kaihara S, Sakamoto S, Okamoto M, Yoshimura N
Department of Transplantation and Regenerative Surgery, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan.
Transplant Proc. 2008 Sep;40(7):2297-8. doi: 10.1016/j.transproceed.2008.06.019.
Patients surviving more than 10 years on hemodialysis (HD) are at risk of developing serious morbidity from unrelated conditions and from the many complications of long-term dialysis, such as cardiovascular disease, cerebrovascular disease, malignant tumors ectopic vascular calcification, diabetes mellitus, and disuse atrophy of the bladder. Long-term dialysis affects transplant patient outcomes and long-term graft survival. We analyzed 436 patients who underwent kidney transplantations between January 1987 and December 2007 to determine the impact of long-term dialysis on kidney transplant outcomes. The 39 patients who had been treated pretransplantation with dialysis for more than 10 years had an average length of dialysis treatment of 15.8 years (range, 10.0-32.5 years); they were denoted as the long-term hemodialysis group. The remaining 397 recipients showed an average of 3.7 years period of end-stage renal disease (ESRD) (range, 0-9.8, years; short-term hemodialysis group). There were significant differences in patient survival rates between the 2 groups: 93.2% vs 98.6%, at 1 year; 79.3% vs 95.4% at 5 years; and 58.4% vs 93.1% at 10 years (P = .0034). Also, graft survival was significantly different between the 2 groups: 89.2% vs 95.8% at 1 year; 60.4% vs 88.5% at 5 years; and 33.4% vs 80.4% at 10 years (P = .0026). Our results suggest that dialysis treatment for more than 10 years produces negative effects on post-transplantation patient and graft survival.
接受血液透析（HD）超过10年的患者有因无关病症以及长期透析的诸多并发症而发生严重发病的风险，这些并发症包括心血管疾病、脑血管疾病、恶性肿瘤、异位血管钙化、糖尿病以及膀胱失用性萎缩。长期透析会影响移植患者的预后及移植物的长期存活。我们分析了1987年1月至2007年12月期间接受肾移植的436例患者，以确定长期透析对肾移植预后的影响。39例移植前接受透析治疗超过10年的患者，透析治疗的平均时长为15.8年（范围为10.0 - 32.5年）；他们被归为长期血液透析组。其余397例受者的终末期肾病（ESRD）平均时长为3.7年（范围为0 - 9.8年；短期血液透析组）。两组患者的生存率存在显著差异：1年时分别为93.2%对98.6%；5年时分别为79.3%对95.4%；10年时分别为58.4%对93.1%（P = .0034）。此外，两组的移植物存活率也存在显著差异：1年时分别为89.2%对95.8%；5年时分别为60.4%对88.5%；10年时分别为33.4%对80.4%（P = .0026）。我们的结果表明，透析治疗超过10年会对移植后患者及移植物存活产生负面影响。
