Lee S H, Oh C-K, Shin G T, Kim H, Kim S J, Kim S I
Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Transplant Proc. 2014;46(2):449-53. doi: 10.1016/j.transproceed.2013.10.049.
Donor and recipient age in kidney transplantation are known to affect graft and patient survival. To address the question of whether the age difference between donor and recipient impacts on graft survival and death-censored graft survival after transplantation, we examined the impact of age matching (less than 10-year age difference) on the survivals after living donor kidney transplantation.
Two hundred one cases of the primary living donor kidney transplantation were performed and were divided into two groups, age-matched (n = 123) versus age-discrepant (n = 78). Variables included in this study were age, gender, body weight, height, kidney disease, type and duration of dialysis before transplantation, degree of human leukocyte antigen mismatch, ischemic time, graft weight, episode of rejection, type of immunosuppression, recipient serum creatinine after transplantation, and causes of patient death and graft loss.
We observed the disparities of graft survival (P = .008) and death-censored graft survival (P = .003) between the groups. One-, 3-, and 5-year death-censored graft survival was 100%, 100%, and 97% in the age-matched group, respectively; and 97%, 90%, and 88% in the age-discrepant group, respectively. By Cox regression multivariate analysis, the variable of age-matching was an independent predictor for both graft survival (ß = 1.325, P = .017) and death-censored graft survival (ß = 2.217, P = .021).
During living donor and recipient matching, age difference between donor and recipient should be minimized.
肾移植中供体和受体的年龄已知会影响移植物和患者的存活。为了探讨供体与受体之间的年龄差异是否会影响移植后的移植物存活和死亡删失移植物存活，我们研究了年龄匹配（年龄差异小于10岁）对活体供肾移植后存活的影响。
进行了201例初次活体供肾移植，并分为两组，年龄匹配组（n = 123）和年龄不匹配组（n = 78）。本研究纳入的变量包括年龄、性别、体重、身高、肾脏疾病、移植前透析类型和时间、人类白细胞抗原错配程度、缺血时间、移植物重量、排斥反应发作、免疫抑制类型、移植后受体血清肌酐以及患者死亡和移植物丢失的原因。
我们观察到两组之间移植物存活（P = .008）和死亡删失移植物存活（P = .003）存在差异。年龄匹配组1年、3年和5年的死亡删失移植物存活率分别为100%、100%和97%；年龄不匹配组分别为97%、90%和88%。通过Cox回归多变量分析，年龄匹配变量是移植物存活（β = 1.325，P = .017）和死亡删失移植物存活（β = 2.217，P = .021）的独立预测因素。
在活体供体与受体匹配过程中，应尽量缩小供体与受体之间的年龄差异。
