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75岁以上已故捐赠者的肾脏在移植后表现良好。

Kidneys from deceased donors more than 75 years perform acceptably after transplantation.

作者信息

Foss Aksel, Heldal Kristian, Scott Helge, Foss Stein, Leivestad Torbjørn, Jørgensen Pål Foyn, Scholz Tim, Midtvedt Karsten

机构信息

Division of Surgery, Section for Transplantation, Rikshospitalet University Hospital, Oslo, Norway.

出版信息

Transplantation. 2009 May 27;87(10):1437-41. doi: 10.1097/TP.0b013e3181a4ebd2.

Abstract

BACKGROUND

Organ shortage has resulted in an increased use of expanded criteria donors for transplantation, in particular kidneys from older donors. There is limited data on the impact of donor age more than 75 years on kidney transplant outcome.

METHODS

A retrospective single-center analysis on deceased donors more than 75 years and kidney transplant outcome in an old for old setting was performed. Histologic findings (global kidney score) in graft biopsies and deceased-donor scores were evaluated to observe if this information could be helpful in predicting outcome.

RESULTS

Evaluation of data from 54 single kidney transplantations from 29 donors more than 75 years (median 77.5, range 75.2-86.1) were assessed. Ninety-three percent of the donors died of intracranial bleeding, and 69% had a history of hypertension or cardiovascular event(s). Median recipient age was 70.1 (range 50.6-82.4). Fifty-two grafts (96%) had posttransplant function. Death censored graft survival at 1, 3, and 5 years were 87%, 83%, and 83%, respectively. Patient survival was 81%, 75%, and 59% at the same time points. At follow-up at median 23 months (range 6-144 months), thirty-five recipients were alive with a median serum creatinine of 163 micromol/ L (range 103-348). Global kidney score and deceased donor score did not predict graft outcome.

CONCLUSION

Kidney transplants from deceased donors more than 75 years perform acceptable as single transplants and should be considered for use in older recipients.

摘要

背景

器官短缺导致扩大标准供体在移植中的使用增加,尤其是来自老年供体的肾脏。关于75岁以上供体年龄对肾移植结果影响的数据有限。

方法

对75岁以上的已故供体及老年受者肾移植结果进行了一项回顾性单中心分析。评估移植肾活检的组织学结果(整体肾脏评分)和已故供体评分,以观察该信息是否有助于预测结果。

结果

评估了来自29名75岁以上供体(中位年龄77.5岁,范围75.2 - 86.1岁)的54例单肾移植数据。93%的供体死于颅内出血,69%有高血压或心血管事件史。受者中位年龄为70.1岁(范围50.6 - 82.4岁)。52个移植物(96%)移植后有功能。1年、3年和5年的死亡截尾移植物存活率分别为87%、83%和83%。在相同时间点,患者存活率分别为81%、75%和59%。中位随访23个月(范围6 - 144个月)时,35名受者存活,中位血清肌酐为163微摩尔/升(范围103 - 348)。整体肾脏评分和已故供体评分不能预测移植物结果。

结论

75岁以上已故供体的肾移植作为单肾移植效果尚可,应考虑用于老年受者。

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