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中国50岁以上亲属活体肾移植的临床分析

Clinical analysis of living related renal transplantation with donors older than 50 years in China.

作者信息

Guo F F, Shao Z-Q, Yang W-Y, Wang G-J, Tan S-F, He X-F, Wang J-M, Liu H J, Li Y, Sun F G, Zhu W-B

机构信息

Center of Kidney Transplantation, Linyi People’s Hospital, Shandong, China.

出版信息

Transplant Proc. 2010 Sep;42(7):2471-6. doi: 10.1016/j.transproceed.2010.04.038.

Abstract

OBJECTIVE

The objective of this study was to investigate whether kidney grafts from living related donors older than 50 years were safe for the donors and recipients in the long term.

METHODS

One hundred seven living related donor kidney transplantations were performed in our center from April 1994 to December 2007. No prisoners or organs from prisoners were used in the collection of these data. Donors were divided into 2 groups: >50 years of age (range, 51-78 years), designated as the study group, and ≤50 years of age (range, 21-50 years), designated as the control groups. The mean time of follow-up was 49 months (range, 12-180 months). Clinical data were compared, including donor serum creatinine (Scr) levels, glomerular filtration rates (GFR) before and after the procedures operative complications, and postoperative short-term and long-term recovery of renal function in recipients as well as their complications and recipient and kidney survivals.

RESULTS

All operations were successfully performed. Before the operation, the mean Scr and GFR were 82.16 ± 10.86 umol/L and 85.82 ± 6.26 mL/min, respectively, in the study group versus 78.66 ± 10.41 umol/L and 88.74 ± 9.44 mL/min, respectively, in the control group. There were no significant differences in mean Scr or GFR values between the groups at various preoperative or postoperative times (P > .05). No severe perioperative complications occurred, and no subsequent renal function failure was observed upon long-term follow-up of donors in the 2 groups. Comparisons of recipient age, gender ratio, duration on dialysis, HLA matches, cold/warm ischemia times, and immunosuppression therapy showed a correlations between the 2 groups. Mean Scr levels of recipients, which were compared from 1 week to 3 years following surgery, were slightly higher among the control than the study group, but the difference was not significant (P > .05). There were no significant differences between the study and control groups in 1-,3-,5-, and 8-year recipient/graft survival rates (P > .05).

CONCLUSIONS

Long-term follow-up showed that transplantations using grafts from donors older than 50 years of age yielded similar results to those with younger donors.

摘要

目的

本研究旨在调查50岁以上活体亲属供肾移植对供者和受者长期而言是否安全。

方法

1994年4月至2007年12月期间,在本中心进行了107例活体亲属供肾移植手术。收集这些数据时未使用囚犯或囚犯的器官。将供者分为2组:年龄>50岁(范围51 - 78岁),指定为研究组;年龄≤50岁(范围21 - 50岁),指定为对照组。平均随访时间为49个月(范围12 - 180个月)。比较临床数据,包括供者血清肌酐(Scr)水平、手术前后的肾小球滤过率(GFR)、手术并发症以及受者术后短期和长期肾功能恢复情况及其并发症以及受者和肾脏存活率。

结果

所有手术均成功完成。术前,研究组的平均Scr和GFR分别为82.16±10.86μmol/L和85.82±6.26 mL/min,而对照组分别为78.66±10.41μmol/L和88.74±9.44 mL/min。在术前或术后不同时间,两组间平均Scr或GFR值无显著差异(P>.05)。未发生严重围手术期并发症,两组供者长期随访均未观察到随后的肾功能衰竭。对受者年龄、性别比、透析时间、HLA配型、冷/热缺血时间和免疫抑制治疗的比较显示两组间存在相关性。术后1周至3年比较受者的平均Scr水平,对照组略高于研究组,但差异不显著(P>.05)。研究组和对照组在1年、3年、5年和8年的受者/移植物存活率方面无显著差异(P>.05)。

结论

长期随访表明,使用50岁以上供者的移植物进行移植与年轻供者的移植结果相似。

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