Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia.
Nephrology (Carlton). 2010 Feb;15(1):124-32. doi: 10.1111/j.1440-1797.2009.01199.x.
Allocation of deceased-donor kidneys in Australia often involves the shipping of well-matched renal allografts across states. However, the impact of shipping on graft outcomes remains unclear. In this study, the effect of shipping of well-matched (0-2 human leucocyte antigen (HLA) mismatches) and poorer-matched (3-6 HLA mismatches) deceased-donor kidneys on transplant outcomes in Australia were examined.
Using data from Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), graft and patient outcomes were compared between shipped and locally transplanted allografts in Australia between 1992 and 2007 stratified by the number of HLA mismatches.
Recipients receiving shipped renal allografts were more likely to be highly sensitized with previous grafts and/or higher panel reactive antibodies levels with significantly longer graft ischaemic time compared to local allografts. Regardless of the HLA mismatches, the risk of delayed graft function, acute rejection, 12 month serum creatinine, graft failure and patient survival was similar between shipped and locally transplanted renal allografts.
Recipients of shipped renal allografts with 0-2 and 3-6 HLA mismatches have similar transplant outcomes to locally transplanted allografts.
在澳大利亚，分配已故供体的肾脏通常涉及将匹配良好的肾移植物跨越州际运输。然而，运输对移植物结果的影响尚不清楚。本研究旨在探讨匹配良好（0-2 个人类白细胞抗原（HLA）错配）和匹配较差（3-6 HLA 错配）的已故供体肾脏在澳大利亚通过运输对移植结果的影响。
利用澳大利亚和新西兰透析和移植登记处（ANZDATA）的数据，根据 HLA 错配的数量，比较了 1992 年至 2007 年间在澳大利亚进行的运输和本地移植的同种异体移植物之间的移植物和患者结局。
与本地移植物相比，接受运输的肾移植物的受者更有可能具有先前的移植物致敏和/或更高的面板反应性抗体水平，并且移植物缺血时间明显更长。无论 HLA 错配如何，运输和本地移植的肾移植物之间延迟移植物功能、急性排斥反应、12 个月血清肌酐、移植物失功和患者存活率的风险相似。
接受 0-2 和 3-6 HLA 错配的运输肾移植物的受者与接受本地移植的移植物具有相似的移植结局。
