Department of Renal Transplant, Queen Elizabeth Hospital, Adelaide, Australia.
Transpl Int. 2010 May 1;23(5):476-83. doi: 10.1111/j.1432-2277.2009.01002.x. Epub 2009 Dec 8.
We report the outcomes of renal transplant patients (n = 43) who received grafts from donors (n = 41) with small (<3 cm) renal tumours removed before transplantation covering the period from May 1996 to September 2007. Patient and graft survival were compared with the outcomes of conventional live unrelated transplants (LURTs) (n = 120) and to patient survival on the transplant waiting list for those who did not receive a kidney during this period (n = 153). Patient survival at 1, 3 and 5 years were 92%, 88% and 88% for recipients of tumourectomized kidneys (TKs), 99%, 97% and 97% for LURTs, and 98%, 92% and 74% for dialysis patients waiting for a deceased donor kidney (log rank score 10.4, P = 0.005). One patient experienced a local tumour recurrence at 9 years following transplantation. This patient declined intervention and is currently under active surveillance. Transplantation of tumourectomized kidneys from patients with small, localized, incidentally detected renal tumours results in similar outcomes to conventional LURTs and confers a significant survival advantage for patients who would otherwise be unable to receive a transplant.
我们报告了 43 名接受移植的患者(n=43)的结果,这些患者的供体(n=41)在移植前切除了小(<3cm)的肾肿瘤,时间跨度从 1996 年 5 月到 2007 年 9 月。比较了患者和移植物的存活率,与传统的活体非亲属移植(LURT)(n=120)的结果进行比较,以及在这段时间内未接受肾脏移植的患者在移植等待名单上的存活率(n=153)。接受肿瘤切除术的肾脏移植患者(TKs)的 1、3 和 5 年患者存活率分别为 92%、88%和 88%,LURTs 为 99%、97%和 97%,而透析患者等待已故供体肾脏的存活率为 98%、92%和 74%(对数秩得分 10.4,P=0.005)。一名患者在移植后 9 年出现局部肿瘤复发。该患者拒绝干预,目前正在积极监测中。从小、局限性、偶然发现的肾肿瘤患者中移植肿瘤切除术的肾脏,结果与传统的 LURT 相似,并为那些否则无法接受移植的患者带来显著的生存优势。