Sesso R, Anção M S, Draibe S A, Sigulem D, Ramos O L
Department of Medicine, Escola Paulista de Medicina, São Paulo, Brazil.
Nephrol Dial Transplant. 1990;5(11):956-61. doi: 10.1093/ndt/5.11.956.
Little is known about renal transplantation activity in developing countries. The objective of this study was to evaluate patient and graft survival among the different types of renal transplant recipients in Brazil. The study population consisted of 1563 patients receiving renal grafts for the first time between 1 October 1987 and 31 December 1989 in 49 transplant centres in Brazil. Data were prospectively collected through individual patient questionnaires. Of the 1563 transplantations performed, 1051 (67%) were from living donors, 467 (30%) from cadaver donors, and 45 (3%) unspecified. A total of 963 (62%) transplants came from living related donors (10% HLA-identical, 45% HLA-haploidentical and 6% HLA-distinct). Among the transplant recipients, only 7% were more than 55 years old, 5% were younger than 15 and 4% had diabetes mellitus. Blacks accounted for 24% of patients receiving transplants. An immunosuppressive regimen, including cyclosporin was used in 75% of cadaver kidney recipients, in 42% of living donor kidney recipients; and in 43% and 75% of HLA-haploidentical and HLA-distinct living related donor recipients, respectively. At 2 years, patient survival for living donor and cadaver donor transplant recipients was 89% and 80% respectively, and graft survival was 76% and 61% respectively. Patient survival for recipients of HLA-identical, haploidentical, and distinct living related donor kidneys was respectively 94%, 90%, and 81% at 2 years, and graft survival was 90%, 75%, and 65% respectively. Graft survival for recipients of HLA-distinct living related donor and non-related donor kidneys compared to cadaver donor kidneys was not significantly different at 2 years (63% vs 61%, P greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
关于发展中国家的肾移植活动，人们了解甚少。本研究的目的是评估巴西不同类型肾移植受者的患者和移植物存活率。研究人群包括1987年10月1日至1989年12月31日期间在巴西49个移植中心首次接受肾移植的1563例患者。数据通过个体患者问卷前瞻性收集。在进行的1563例移植中，1051例（67%）来自活体供者，467例（30%）来自尸体供者，45例（3%）来源未明确。共有963例（62%）移植来自活体亲属供者（10% HLA全相合，45% HLA半相合，6% HLA不相合）。在移植受者中，仅7%年龄超过55岁，5%年龄小于15岁，4%患有糖尿病。黑人占接受移植患者的24%。75%的尸体肾受者、42%的活体供肾受者使用了包括环孢素在内的免疫抑制方案；在HLA半相合和HLA不相合的活体亲属供肾受者中，分别有43%和75%使用了该方案。2年时，活体供肾和尸体供肾移植受者的患者存活率分别为89%和80%，移植物存活率分别为76%和61%。2年时，HLA全相合、半相合和不相合的活体亲属供肾受者的患者存活率分别为94%、90%和81%，移植物存活率分别为90%、75%和65%。2年时，HLA不相合的活体亲属供肾和非亲属供肾受者的移植物存活率与尸体供肾受者相比无显著差异（63%对61%，P大于0.05）。（摘要截于250字）
