Ann Arbor Veterans Affairs Medical Center, Ann Arbor, MI, USA.
Drugs Aging. 2014 Feb;31(2):103-9. doi: 10.1007/s40266-013-0149-x.
Kidney transplantation is currently the best treatment for end-stage renal disease, both in terms of mortality benefit and quality of life (QOL). Elderly patients are a rapidly growing subset of the kidney transplant waiting list. While it is clear that elderly individuals have a mortality benefit from kidney transplant, it is less clear how to make sure these individuals benefit from optimal QOL following transplant. Several studies demonstrate superiority of some immunosuppressive regimens over others in the QOL domain. Tacrolimus has been shown to be associated with better QOL than cyclosporine (ciclosporin), as has corticosteroid-free immunosuppressive regimens. Similarly, patients on drug regimens, which tend to lessen the side effects, report better QOL. However, these studies are observational or cross-sectional and not focused exclusively on the elderly patient. More studies are needed to determine optimal immunosuppression regimens for elderly individuals. Additionally, further studies on determinants of QOL in elderly kidney transplant recipients are also needed.
肾移植是目前治疗终末期肾病的最佳方法，无论是在死亡率获益还是生活质量（QOL）方面。老年患者是肾移植等待名单中迅速增长的一部分。虽然很明显，老年患者从肾移植中获得了死亡率获益，但如何确保这些患者在移植后获得最佳的生活质量还不太清楚。几项研究表明，在 QOL 方面，某些免疫抑制方案优于其他方案。与环孢素（环孢菌素）相比，他克莫司与更好的 QOL 相关，无皮质类固醇免疫抑制方案也是如此。同样，使用药物方案的患者报告说生活质量更好，这些药物方案往往可以减轻副作用。然而，这些研究是观察性或横断面的，并非专门针对老年患者。需要更多的研究来确定老年患者的最佳免疫抑制方案。此外，还需要进一步研究老年肾移植受者生活质量的决定因素。
