Transplantation Research Center, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Nephron Clin Pract. 2009;113(4):c241-9. doi: 10.1159/000235248. Epub 2009 Aug 15.
BACKGROUND/AIMS: The greater use of living unrelated donors (LUDs) as kidney donors is a worldwide trend in the current era of organ shortage, and spouses are an important source of LUDs. This study was to compare the long-term outcomes of spousal donor grafts with other LUD grafts.
Among 445 LUD grafts, 77 were spouses and 368 were other LUDs. The clinical characteristics and long-term survival rates for spousal transplants were compared with those for other LUD transplants, and risk factors affecting graft survival were assessed.
Spousal donors had a significantly higher average number of human leukocyte antigen (HLA) mismatches (4.2 vs. 3.4, p < 0.001) and were older (41 vs. 33 years, p < 0.001) than LUDs. The 10-year survival rates for spousal donor grafts were 60.6%, similar to those for LUD grafts (58.5%, p = 0.61). The 10-year biopsy-proven acute rejection-free survival rates (85.5 vs. 89.6%, p = 0.45) and patient survival rates were also similar (84.3 vs. 79.6%, p = 0.35). The degree of HLA mismatching, the spousal donor type or donor age did not affect the graft survival.
Renal transplants from spousal donors show similar long-term outcomes to those from better HLA-matched and younger LUDs.
背景/目的：在当前器官短缺的时代，越来越多的使用活体非亲属供者（LUD）作为肾脏供者是一种全球趋势，而配偶是 LUD 的重要来源。本研究旨在比较配偶供体移植物与其他 LUD 移植物的长期结局。
在 445 例 LUD 移植物中，有 77 例为配偶，368 例为其他 LUD。比较配偶移植与其他 LUD 移植的临床特征和长期存活率，并评估影响移植物存活率的危险因素。
配偶供者的人类白细胞抗原（HLA）错配平均数量（4.2 对 3.4，p < 0.001）和年龄（41 对 33 岁，p < 0.001）均显著高于 LUD。配偶供体移植物的 10 年存活率为 60.6%，与 LUD 移植物相似（58.5%，p = 0.61）。10 年活检证实的急性排斥反应无复发存活率（85.5 对 89.6%，p = 0.45）和患者存活率也相似（84.3 对 79.6%，p = 0.35）。HLA 错配程度、配偶供体类型或供体年龄均不影响移植物存活率。
配偶供体的肾脏移植与 HLA 匹配更好和年龄更小的 LUD 移植物具有相似的长期结局。
