Freitas Maria Cecilia S
Terasaki Foundation Laboratory, Los Angeles, California, USA.
Clin Transpl. 2011:1-16.
As of January 14, 2011, 112,707 individuals were listed for kidney transplant. In the past 5 years the yearly average of deceased donor and living donor kidney-only transplants was 10,052 and 6,153, respectively. Compared with a previous decade, one-, 3- and 5-year graft survival rates for deceased donor kidney transplants increased 5%, 6%, and 6%, respectively. Long-term graft survival has not really improved over the past 2 decades. During the past decade, the percentage of kidneys from deceased donors over age 60 transplanted in patients of the same age group increased (from 29% to 60%) over the previous decade. The number of kidney transplants through paired-exchange donation was 109 in 2007. In 2010, that number almost quadrupled to 421. The number of unrelated living donors (LD) has also increased dramatically over the past decade, accounting for 28% of all LD transplants in 2010, and being the major source of LD kidney transplants since 2008. The combination of male donor and female recipient yielded the highest short- and long-term graft survival rates. Female donor and male recipient had the lowest short- and long-term graft survival rates. The risk of graft loss with female donor and male recipient was 23% higher than with male donor and female recipient. For re-transplants, risk of graft loss was 48% higher in patients who received no induction than in those who received IL-2RA + steroid. The impact of HLA mismatch on graft survival rates has declined, but it remains significant. There is still a 10% decrease in the 5-year graft survival from zero MM (77%) to 5&6 MM (67%) in the more recent years. National sharing of zero HLA-mismatched kidneys to sensitized adults with PRA > 20% has increased the transplant opportunity for more highly sensitized patients, nevertheless it will also indirectly decreased the benefits in survival that zero HLA-mismatches provides to about 6% of the kidney transplant population each year who were not sensitized. As of June 2011, 198,314 kidney transplant recipients were alive with a functioning graft.
截至2011年1月14日，有112,707人登记等待肾移植。在过去5年中，仅来自 deceased donor（脑死亡器官捐献者）和活体捐献者的肾移植年平均数量分别为10,052例和6,153例。与前一个十年相比，deceased donor肾移植的1年、3年和5年移植肾存活率分别提高了5%、6%和6%。在过去20年中，长期移植肾存活率并未真正提高。在过去十年中，60岁以上deceased donor的肾脏移植到同一年龄组患者中的比例较前一个十年有所增加（从29%增至60%）。2007年通过配对交换捐赠进行的肾移植数量为109例。2010年，这一数字几乎翻了两番，达到421例。在过去十年中，非亲属活体捐献者（LD）的数量也大幅增加，在2010年占所有LD肾移植的28%，自2008年以来一直是LD肾移植的主要来源。男性捐献者与女性受者的组合产生了最高的短期和长期移植肾存活率。女性捐献者与男性受者的短期和长期移植肾存活率最低。女性捐献者与男性受者的移植肾丢失风险比男性捐献者与女性受者高23%。对于再次移植，未接受诱导治疗的患者的移植肾丢失风险比接受白细胞介素-2受体拮抗剂（IL-2RA）+类固醇治疗的患者高48%。HLA错配（人类白细胞抗原错配）对移植肾存活率的影响有所下降，但仍然显著。近年来，从0个错配（MM）（77%）到5个和6个错配（67%），5年移植肾存活率仍有10%的下降。将0个HLA错配的肾脏在全国范围内分配给致敏成人（群体反应性抗体百分比（PRA）>20%）增加了高度致敏患者的移植机会，然而这也将间接降低0个HLA错配对每年约6%的未致敏肾移植人群所提供的生存益处。截至2011年6月，有198,314名肾移植受者存活且移植肾功能良好。 （注：原文中“deceased donor”直译为“已故捐赠者”，在医学语境中更准确的表述可能是“脑死亡器官捐献者”，这里保留英文供你参考，你可根据实际情况调整。）
