Division of Renal Diseases and Hypertension, Transplant Center, University of Colorado Health Sciences Center, Aurora, CO 80045, USA.
Clin Transplant. 2009 Sep-Oct;23(5):732-9. doi: 10.1111/j.1399-0012.2009.01064.x. Epub 2009 Sep 1.
Organ donor characteristics can be used to predict outcomes in kidney transplantation. We hypothesized that pancreas donation status could reflect organ quality and be predictive of kidney graft outcomes following Standard Criteria Donor (SCD) kidney transplantation.
We performed a retrospective analysis of deceased donor kidney alone (DD KA) transplants reported to SRTR from 1992 to 2005. Group 1 = kidney alone recipients from pancreas donors (KA, P+) and Group 2 = kidney alone recipients from non-pancreas donors (KA, P-). We compared patient and graft survival between groups at 10-yr post-transplant.
Group 1 (KA, P+) comprised 19 633 (20%) recipients and Group 2 (KA, P-) comprised 78 737 (80%) recipients. Ten-yr graft survival for Group 1 vs. Group 2 was 42.6% and 36.9% (p < 0.0001), respectively. Pancreas donation status (non-pancreas donor) was associated with a hazard ratio for graft loss of 1.23 on univariate analysis (p < 0.0001), and KA, P-remained an independent risk factor for graft failure at 10 yr, HR 1.09 (p < 0.0001).
Donor pancreas donation status is an independent predictor of improved outcomes of SCD kidney recipients. Further study of the pancreas organ donor pre-procurement is warranted to optimize not only pancreas utilization but also kidney graft outcomes.
器官捐献者的特征可用于预测肾移植的结果。我们假设胰腺捐献状态可以反映器官质量，并可预测标准供体（SCD）肾移植后肾脏移植物的结局。
我们对 1992 年至 2005 年 SRTR 报告的单独肾移植（DDKA）进行了回顾性分析。组 1=来自胰腺供体的单独肾受者（KA，P+），组 2=来自非胰腺供体的单独肾受者（KA，P-）。我们比较了两组患者在移植后 10 年的患者和移植物存活率。
组 1（KA，P+）包括 19633（20%）名受者，组 2（KA，P-）包括 78737（80%）名受者。组 1和组 2的 10 年移植物存活率分别为 42.6%和 36.9%（p<0.0001）。单因素分析显示，胰腺捐献状态（非胰腺捐献者）与移植物丢失的风险比为 1.23（p<0.0001），KA，P-在 10 年内仍是移植物衰竭的独立危险因素，HR 为 1.09（p<0.0001）。
供体胰腺捐献状态是 SCD 肾移植受者结局改善的独立预测因素。进一步研究胰腺器官供体的术前情况不仅可以优化胰腺的利用，还可以改善肾脏移植物的结局。
