Chamienia A, Dębska-Ślizień A, Rutkowski B, Zadrożny D, Moszkowska G
Department of Nephrology, Transplantation, and Internal Diseases, Gdańsk Medical University, Gdańsk, Poland.
Transplant Proc. 2011 Oct;43(8):2911-3. doi: 10.1016/j.transproceed.2011.08.027.
Living-donor kidney transplantation (LDKT) is a viable option that is characterized by better short- and long-term results than cadaver-donor kidney transplantation (CKT). In Poland number of LDKT is low (2%-3%). We collected data on all 29 LDKTs performed in our center between 1999 and 2010; 82.7% were obtained from living related donors. The mean recipient age was 34.4±12.8 years (range, 15-58) and mean donor age was 48.5±7 years. Most donors were women (n=17; 62%). In 3 cases the LDKT was a second transplantation. The mean numbers of HLA class I and II mismatches were 2.18±0.98 and 0.93±0.6 respectively. The mean total ischemia time was 3.22±1.74 hours. Induction therapy included antithymocyte globulin daclizumab 4; (13.7%) (n=7; 24.1%); 27.6% of recipients were placed on cyclosporine based immunosuppression and the remaining 72.4% on tacrolimus with 69% also receiving mycophenolate mofetil. All recipients were prescribed steroids. Delayed graft function was observed in 3 cases and an acute rejection episode in 4 subjects. One-year patient and graft survivals were both 100% (98% and 83% for CKT). Five-year patient and graft survival were 100% and 89.6%, respectively, compared with 83% and 69% in CKT. The mean serum creatinine levels at 1, 6, 12, and 60 months were 1.59±0.4, 1.51±0.3, 1.51±0.4 and 1.49±0.3 mg/dL respectively. Our results, albeit concerning a small group of patients, confirmed excellent outcomes of LDKT, which should be actively promoted in our country.
活体供肾肾移植(LDKT)是一种可行的选择,其短期和长期效果均优于尸体供肾肾移植(CKT)。在波兰,LDKT的数量较少(2%-3%)。我们收集了1999年至2010年间在我们中心进行的所有29例LDKT的数据;82.7%的供肾来自活体亲属供者。受者的平均年龄为34.4±12.8岁(范围为15-58岁),供者的平均年龄为48.5±7岁。大多数供者为女性(n=17;62%)。3例LDKT为再次移植。HLAⅠ类和Ⅱ类错配的平均数分别为2.18±0.98和0.93±0.6。总的平均缺血时间为3.22±1.74小时。诱导治疗包括抗胸腺细胞球蛋白(达利珠单抗)4例(13.7%)(n=7;24.1%);27.6%的受者接受基于环孢素的免疫抑制治疗,其余72.4%接受他克莫司治疗,69%的受者还接受霉酚酸酯治疗。所有受者均使用了类固醇。3例出现移植肾功能延迟恢复,4例发生急性排斥反应。1年时患者和移植肾存活率均为100%(CKT分别为98%和83%)。5年时患者和移植肾存活率分别为100%和本89.6%,而CKT分别为8面3%和69%。1、6、12和60个月时的平均血清肌酐水平分别为1.59±0.4、1.51±0.3、1.51±0.4和1.49±0.3mg/dL。我们的研究结果尽管涉及的患者群体较小,但证实了LDKT的良好效果,在我国应积极推广。