Yasumura T, Oka T, Omori Y, Nakane Y
Second Department of Surgery, Kyoto Prefectural University of Medicine, Japan.
Jpn J Surg. 1991 Mar;21(2):138-44. doi: 10.1007/BF02470900.
The long-term patient and graft survivals, causes of death, complications and rehabilitation status in the second decade were analyzed in 114 patients who received living related kidney transplants and were followed up for 10 years or longer. Azathioprine and prednisolone were used for basal immunosuppressive therapy in all patients. The actual patient and graft survival rates at 10 years were 76.3 per cent and 50.9 per cent respectively, the main causes of death being serious infection (10 cases), malignant disease (5 cases), cerebral bleeding (4 cases), hepatic failure (3 cases), gastrointestinal bleeding (2 cases) and cardiovascular disorder (2 cases). Four patients died from complications after re-admission for hemodialysis. The cumulative patient and graft survival rates at 15 years in 58 patients whose graft survived for over 10 years were 87 per cent and 75 per cent, respectively. Of the 51 patients still surviving at the end of the study, the complete rehabilitation rate was 90.2 per cent, however, de novo malignant disease and hepatic disorder were significant complications which not only disturbed the patients' quality of life but also reduced their survival rate. Therefore, regular follow-up of patients and appropriate management procedures are necessary to enhance the long-term success of kidney transplantation.
对114例接受亲属活体肾移植并随访10年及以上的患者,分析了其第二个十年的长期患者和移植物存活率、死亡原因、并发症及康复状况。所有患者均使用硫唑嘌呤和泼尼松龙进行基础免疫抑制治疗。10年时患者和移植物的实际存活率分别为76.3%和50.9%,主要死亡原因包括严重感染(10例)、恶性疾病(5例)、脑出血(4例)、肝衰竭(3例)、胃肠道出血(2例)和心血管疾病(2例)。4例患者因再次入院进行血液透析后出现并发症死亡。58例移植物存活超过10年的患者15年时的累积患者和移植物存活率分别为87%和75%。在研究结束时仍存活的51例患者中,完全康复率为90.2%,然而,新发恶性疾病和肝脏疾病是严重并发症,不仅影响患者生活质量,还降低其存活率。因此,对患者进行定期随访并采取适当的管理措施对于提高肾移植的长期成功率是必要的。