Department of Renal Medicine, University Hospitals Coventry and Warwickshire, Coventry, United Kingdom.
Transplantation. 2010 Jun 27;89(12):1456-61. doi: 10.1097/TP.0b013e3181da6019.
Some Indoasian (IA) patients with established renal failure travel abroad for commercial kidney transplantation. We compared the 1-year outcomes of IA patients from one UK region who received overseas transplants with IA patients receiving local living donor (LD) kidney transplantation, deceased donor (DD) transplantation, and dialysis.
Between 1996 and 2006, 40 adults were transplanted overseas; 38 were IA, and follow-up data were available on 36 patients. Forty IA patients received LD transplants, and 156 patients received DD transplants locally. A cohort of 120 prospective dialysis patients was also used as a comparator group.
In the overseas cohort, 20 patients (56%) were not active in the UK transplant waiting list at the time of kidney transplantation overseas. One-year graft survival was 87%, and 1-year patient survival was 83%. Composite graft and patient survival was 69.5% at 1 year. In the local LD transplant recipients, patient survival was 97.5% (39 of 40; P=0.03), and graft survival was 97.5% (39 of 40; P=0.06). Composite graft and patient survival was 95% (P=0.003). In the overseas group, 42% had major infections compared with 15% in the local group (P=0.02). One-year graft survival for DD transplant was 84.6% (132 of 156), and 1-year patient survival was 93% (145 of 156; P=NS and P=0.06, respectively). In the dialysis group, 1-year patient survival was 96.7% (116 of 120; P=0.001).
IA patients who choose to travel overseas for kidney transplantation have poor clinical outcomes and should be counseled accordingly.
一些来自印度-亚洲（IA）地区的已患有肾衰竭的患者会前往国外进行商业性肾脏移植。我们比较了一个英国地区的 IA 患者在接受海外移植与接受当地活体供者（LD）肾移植、已故供者（DD）移植和透析的 1 年结果。
1996 年至 2006 年间，有 40 名成年人在海外接受了移植；其中 38 名是 IA，有 36 名患者的随访数据可用。40 名 IA 患者接受了 LD 移植，156 名患者在当地接受了 DD 移植。还使用了 120 名前瞻性透析患者作为对照组。
在海外队列中，20 名患者（56%）在海外进行肾脏移植时未在英国移植等待名单上活跃。1 年移植物存活率为 87%，1 年患者存活率为 83%。1 年时复合移植物和患者存活率为 69.5%。在当地 LD 移植受者中，患者存活率为 97.5%（40 例中的 39 例；P=0.03），移植物存活率为 97.5%（40 例中的 39 例；P=0.06）。复合移植物和患者存活率为 95%（P=0.003）。在海外组中，42%的患者发生了重大感染，而当地组中这一比例为 15%（P=0.02）。DD 移植的 1 年移植物存活率为 84.6%（156 例中的 132 例），1 年患者存活率为 93%（156 例中的 145 例；P=无统计学差异和 P=0.06，分别）。在透析组中，1 年患者存活率为 96.7%（120 例中的 116 例；P=0.001）。
选择前往海外进行肾脏移植的 IA 患者临床结局较差，应相应地对其进行咨询。
