Patel Himanshu V, Kute Vivek B, Ghelani Ghanshyam H, Vanikar Aruna V, Shah Pankaj R, Gumber Manoj R, Trivedi Hargovind L
Department of Nephrology and Clinical Transplantation, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, India.
Saudi J Kidney Dis Transpl. 2013 Mar;24(2):403-7. doi: 10.4103/1319-2442.109618.
Renal transplantation (RTx) is considered as the best therapeutic modality for patient suffering from end-stage renal disease (ESRD). Dearth of donor kidneys is a major problem everywhere, and deceased donor renal transplantation (DDRTx) is seen as at least a partial solution. Even so, DDRTx accounts for only less than 4% of RTx in India. We report our 6-year single-center experience on DDRTx vis-à-vis patient/graft survival, graft function in terms of serum creatinine (SCr), rejection episodes, and delayed graft function (DGF). Between January 2005 and March 2011, 236 DDRTx were performed. Majority of the donors were those with brain death due to road traffic/cerebrovascular accidents. The commonest recipient diseases leading to ESRD were chronic glomerulonephritis (42.8%), diabetes (12.7%), and hypertension (10.6%). Mean recipient age was 36.2 ± 14.2 years; 162 were males and 74 were females. Mean donor age was 45.3 ± 17.13 years; 144 were males and 92 were females. Mean dialysis duration pre-transplantation was 18.5 ± 2.5 months. All recipients received single-dose rabbit-anti-thymocyte globulin induction and steroids, calcinueurin inhibitor, and mycophenolate mofetil/azathioprine for maintenance immunosuppression. Delayed graft function was observed in 29.6% patients and 22% had biopsy-proven acute rejection. Over the mean follow-up of 2.18 ± 1.75 years, patient and graft survival rates were 74.57% and 86.8%, respectively, with mean SCr of 1.42 ± 0.66 mg%. DDRTx achieves acceptable graft function with patient/graft survival, encouraging the use of this approach in view of organ shortage.
肾移植（RTx）被认为是终末期肾病（ESRD）患者的最佳治疗方式。供体肾短缺在各地都是一个主要问题，而尸体供肾移植（DDRTx）被视为至少是部分解决方案。即便如此，在印度，DDRTx仅占RTx的不到4%。我们报告了我们在DDRTx方面6年的单中心经验，涉及患者/移植物存活情况、以血清肌酐（SCr）衡量的移植物功能、排斥反应发作情况以及延迟性移植物功能（DGF）。2005年1月至2011年3月期间，共进行了236例DDRTx。大多数供体是因道路交通事故/脑血管意外导致脑死亡的患者。导致ESRD的最常见受体疾病是慢性肾小球肾炎（42.8%）、糖尿病（12.7%）和高血压（10.6%）。受体平均年龄为36.2±14.2岁；男性162例，女性74例。供体平均年龄为45.3±17.13岁；男性144例，女性92例。移植前平均透析时间为18.5±2.5个月。所有受体均接受单剂量兔抗胸腺细胞球蛋白诱导治疗以及类固醇、钙调神经磷酸酶抑制剂和霉酚酸酯/硫唑嘌呤进行维持免疫抑制。29.6%的患者出现延迟性移植物功能，22%的患者经活检证实有急性排斥反应。在平均2.18±1.75年的随访期内，患者和移植物存活率分别为74.57%和86.8%，平均SCr为1.42±0.66mg%。DDRTx在患者/移植物存活方面实现了可接受的移植物功能，鉴于器官短缺，鼓励采用这种方法。
