Second Propedeutic Department of Surgery, University of Athens, Medical School, General Hospital Laiko, 17 Agiou Thoma str, 11527 Athens, Greece.
Int Urol Nephrol. 2011 Dec;43(4):1211-9. doi: 10.1007/s11255-011-9930-0. Epub 2011 Mar 4.
The utilization of kidney grafts from expanded criteria donors (ECDs) needs to be evaluated within the context of critical organ shortage and graft function and survival. The impact of donor risk variables on kidney transplantation (KTx) outcome was investigated.
A retrospective review of 75 KTxs from ECDs over a 5-year period was performed. Donor risk factors were analyzed separately and correlated with recipients graft function and survival.
Sixty-four recipients out of 75 (85.3%) had functioning grafts 5 years post-transplant. The overall actuarial graft survival rates at 1 through 5 years were 87.5, 68.1, 57.3, 55.4, and 47.3%, respectively. Forty-seven kidneys (62.7%) had early function with actuarial survival of 100.0, 88.3, 75.8, 75.8, and 68.4% at 1-5 years post-transplant, and 28 (37.3%) grafts presented delayed function with substantially decreased actuarial survival, ranging from 66.7 to 23.2%. KTxs from elderly donors had remarkable actuarial survival rates ranging from 100.0 to 67.0%, at 1-5 years, being the best graft survival rates among KTxs from other donor categories. The other donor risk variables when associated with old age had an adverse effect on recipient graft function and survival, but none alone or a combination of the two, showed any significant statistical variability.
ECDs significantly increased the kidney pool and can be utilized safely if adequate measures are taken.
在严重的器官短缺和移植物功能及存活的背景下，需要评估从扩大标准供者（ECD）获取的肾移植物的利用率。本研究调查了供者风险变量对肾移植（KTx）结果的影响。
回顾性分析了 5 年内 75 例 ECD 肾移植患者。分别分析供者风险因素，并与受者移植物功能和存活相关联。
75 例患者中有 64 例（85.3%）在移植后 5 年时移植物功能正常。1 至 5 年的总累积移植物存活率分别为 87.5%、68.1%、57.3%、55.4%和 47.3%。47 个肾脏（62.7%）有早期功能，1 至 5 年的累积存活率为 100.0%、88.3%、75.8%、75.8%和 68.4%，28 个移植物（37.3%）出现延迟功能，累积存活率显著降低，范围为 66.7%至 23.2%。老年供者的 KTx 具有显著的累积存活率，1 至 5 年分别为 100.0%至 67.0%，在其他供者类别中具有最佳的移植物存活率。当与老年相关的其他供者风险变量对受者移植物功能和存活有不利影响时，但没有任何一个或两者的组合显示出任何显著的统计学差异。
ECD 显著增加了肾脏供体池，如果采取适当的措施，可安全地利用这些供体。
