Gorgulu Numan, Caliskan Yasar, Yelken Berna, Turkmen Aydin
Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Int J Artif Organs. 2010 Jan;33(1):40-4.
Many transplantation teams have attempted renal transplants from living unrelated kidney donors, as well as from cadaveric and living related kidney donors. In this study, we evaluated the results for renal transplants from spousal donors at our center.
We retrospectively analyzed renal transplant patients from spousal donors from 1983 to 2008. A total of 25 patients who underwent a cadaveric donor renal transplant from 1983 to 2008 were also studied as a control group. Patients were evaluated regarding patient and graft survival at 1 and 5 years of follow-up. Acute rejection, delayed graft function, infections, and late complications were recorded.
Thirty-eight male, spousal transplant recipients (group 1), 21 female, spousal transplant recipients (group 2), and 25 cadaveric donor transplant recipients were included this study. Graft survival rates were 96% in group 1 and 100% in group 2 (p=0.76) at 1-year follow-up. Patient survival rates in group 1 and 2 were both 100% at 1-year follow-up. Graft survival rates were 80% in group 1 and 100% in group 2 (p=0.12) at 5-year follow-up. Patient survival rates were 90% in group 1 and 100% in group 2 (p=0.56) at 5-year follow-up. Acute rejection rates were 10% (group 1) and 33% (group 2) (p=0.03); delayed graft function rates were 0% (group 1) and 10% (group 2) (p=0.05); infection rates were 16% (group 1) and 5% (group 2) (p=0.21) as early period posttransplant complications.
Results for transplants between spouses in our groups were comparable to those previously reported in the literature. Acute rejection rates were mildly higher in female recipients than in the male recipients due to pre-sensitization arising from previous pregnancies; however long-term patient and graft survival rates were not significantly different between female and male recipients.
许多移植团队尝试过接受来自非亲属活体供肾者、尸体供肾者以及亲属活体供肾者的肾脏移植。在本研究中，我们评估了在我们中心进行的配偶供肾肾脏移植的结果。
我们回顾性分析了1983年至2008年间配偶供肾的肾脏移植患者。还研究了1983年至2008年间接受尸体供肾肾脏移植的25例患者作为对照组。对患者进行了1年和5年随访时的患者及移植物存活率评估。记录急性排斥反应、移植肾功能延迟恢复、感染及晚期并发症情况。
本研究纳入了38例男性配偶移植受者（第1组）、21例女性配偶移植受者（第2组）以及25例尸体供肾移植受者。1年随访时，第1组移植物存活率为96%，第2组为100%（p=0.76）。第1组和第2组1年随访时患者存活率均为100%。5年随访时，第1组移植物存活率为80%，第2组为100%（p=0.12）。第1组和第2组5年随访时患者存活率分别为90%和100%（p=0.56）。移植后早期并发症方面，急性排斥反应发生率第1组为10%，第2组为33%（p=0.03）；移植肾功能延迟恢复发生率第1组为0%，第2组为10%（p=0.05）；感染发生率第1组为16%，第2组为5%（p=0.21）。
我们组中配偶间移植的结果与文献中先前报道的结果相当。由于既往妊娠导致的预致敏，女性受者的急性排斥反应发生率略高于男性受者；然而，女性和男性受者的长期患者及移植物存活率并无显著差异。
