肾移植中的边缘性活体供者：中国单中心的经验。

Marginal living donor in kidney transplantation: experience in a Chinese single center.

机构信息

Department of Urology, Peking University Third Hospital, Beijing 100191, China.

出版信息

Chin Med J (Engl). 2013;126(15):2810-4.

Abstract

BACKGROUND

Living donor kidney transplantation is becoming popular in China, whereas, in clinical situations, some kidney donors may be sub-optimal, namely marginal living donor. The present study aimed to evaluate the safety and efficacy of marginal living donor kidney transplantation in a Chinese single center.

METHODS

Between January 2001 and December 2009, 888 kidney transplantations were performed in our center; 149 were living donor kidney transplantations. The living donors and recipients were followed up regularly after the operation. Of the living donors, 30 donors were marginal, who were older than 60 years or suffered from kidney anomaly or some benign diseases. Among the non-marginal living kidney transplantations, 58 donors and recipients had complete perioperative and follow-up data. We compared the marginal and non-marginal living donor kidney transplantations with regard to donor age, follow-up period, donor's serum creatinine at the last follow-up, recipient's serum creatinine at the last follow-up, and graft survival at the last follow-up.

RESULTS

The mean age of donors in the marginal and non-marginal living donors were (55 ± 9) (37-66) and (43 ± 12) (30-59) years. The mean follow-up times of the marginal and non-marginal groups were (26.4 ± 13.4) months and (28.8 ± 14.8) months. The donor and recipient serum creatinine levels at the last follow-up were (1.16 ± 0.20) mg/dl and (1.30 ± 0.24) mg/dl in the marginal group, and (1.12 ± 0.32) mg/dl and (1.34 ± 0.32) mg/dl in the non-marginal group. Three recipients in the marginal group and five recipients in the non-marginal group had acute rejection episodes during the first year. Actuarial 3-year graft survival was 96.7% in the marginal group and 100% in the non-marginal group. No significant differences were detected between the two groups with regard to these data.

CONCLUSION

Utilization of highly selective marginal living donors can be a safe, feasible, and effective way for the treatment of patients with end stage renal disease.

摘要

背景

在中国，活体供肾移植越来越受欢迎，然而，在临床情况下，一些供肾者可能并不理想，即边缘供体。本研究旨在评估中国单中心边缘活体供肾移植的安全性和有效性。

方法

2001 年 1 月至 2009 年 12 月，本中心共行 888 例肾移植术，其中 149 例为活体供肾移植。术后对供受者进行定期随访。30 例供者为边缘供者，年龄大于 60 岁或伴有肾脏畸形或良性疾病。非边缘活体供肾移植中，58 例供受者有完整的围手术期及随访资料。比较边缘和非边缘活体供肾移植供者年龄、随访时间、供者末次随访时血肌酐、受者末次随访时血肌酐、移植肾末次随访时存活率。

结果

边缘和非边缘活体供者年龄分别为（55 ± 9）（37-66）岁和（43 ± 12）（30-59）岁。边缘和非边缘组的平均随访时间分别为（26.4 ± 13.4）个月和（28.8 ± 14.8）个月。边缘组供者和受者末次随访时血肌酐分别为（1.16 ± 0.20）mg/dl 和（1.30 ± 0.24）mg/dl，非边缘组分别为（1.12 ± 0.32）mg/dl 和（1.34 ± 0.32）mg/dl。边缘组 3 例受者和非边缘组 5 例受者在第 1 年内发生急性排斥反应。边缘组 3 年移植肾存活率为 96.7%，非边缘组为 100%。两组间上述数据差异无统计学意义。