Schmiedt Chad W, Holzman Gerianne, Schwarz Tobias, McAnulty Jonathan F
Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706-1100, USA.
Vet Surg. 2008 Oct;37(7):683-95. doi: 10.1111/j.1532-950X.2008.00435.x.
To report survival, complications, and analyze risk factors for survival after renal transplantation (RTr) and cyclosporine-A based immunosuppression in cats.
Historical cohort.
Cats (n=60).
Data were obtained from medical records of cats that had RTr. Influence of various perioperative factors on survival and complications was evaluated. Occurrence of postoperative hypertension (HT), seizures, infection, acute allograft rejection (AR), congestive heart failure (CHF), and delayed graft function (DGF) was evaluated.
Survival to discharge after RTr was 77.5%. Estimated median overall survival time was 613 days; 6 month and 3 year overall survival proportions were 65% and 40%, respectively. Age, weight, and blood pressure influenced overall survival. Increased preoperative creatinine concentration, blood urea nitrogen, postoperative creatinine concentration, left ventricular wall thickness, and reduced creatinine reduction ratio influenced survival until discharge. HT was identified in 9/30 (30%) cats; however, no risk factors were identified, nor was HT related to seizures. AR was identified in 8/62 (13%) grafts. Infection, predominantly bacterial, developed in 22/60 (37%) cats. CHF occurred in 7/60 (12%) cats before discharge. Cats experiencing CHF were younger, had an increased incidence of heart murmurs, and poor initial graft function. DGF was identified in 5 cats and seizures in 2 cats.
RTr affords cats with CRF long survival times. Older cats and cats with severe azotemia, HT, and cardiovascular disease may have increased mortality after RTr. Complications after RTr were common.
Clinicians should be aware of these risk factors when recommending feline RTr.
报告猫肾移植（RTr）及基于环孢素A免疫抑制后的生存率、并发症，并分析生存的危险因素。
回顾性队列研究。
猫（n = 60）。
从接受RTr的猫的病历中获取数据。评估各种围手术期因素对生存和并发症的影响。评估术后高血压（HT）、癫痫发作、感染、急性移植肾排斥反应（AR）、充血性心力衰竭（CHF）和移植肾功能延迟恢复（DGF）的发生情况。
RTr后出院生存率为77.5%。估计总体中位生存时间为613天；6个月和3年的总体生存比例分别为65%和40%。年龄、体重和血压影响总体生存。术前肌酐浓度、血尿素氮、术后肌酐浓度、左心室壁厚度增加以及肌酐清除率降低影响出院前的生存。9/30（30%）的猫被诊断为HT；然而，未发现危险因素，HT也与癫痫发作无关。8/62（13%）的移植肾发生AR。22/60（37%）的猫发生感染，主要为细菌感染。7/60（12%）的猫在出院前发生CHF。发生CHF的猫较年轻，心脏杂音发生率增加，初始移植肾功能较差。5只猫被诊断为DGF，2只猫发生癫痫发作。
RTr可使患有慢性肾衰竭的猫获得较长的生存时间。年龄较大的猫以及患有严重氮质血症、HT和心血管疾病的猫在RTr后死亡率可能增加。RTr后的并发症很常见。
临床医生在推荐猫RTr时应了解这些危险因素。
