Galabada Dinith Prasanna, Nazar Abdul L M, Ariyaratne Prasad
Nephrology and Transplant Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.
Saudi J Kidney Dis Transpl. 2014 Nov;25(6):1334-40. doi: 10.4103/1319-2442.144317.
Chronic kidney disease is one of the main public health concerns in Sri Lanka. In comparison with dialysis, successful kidney transplantation improves both patient survival and quality of life, relieves the burden of dialysis in patients suffering from end-stage renal disease and decreases the cost of healthcare to the society and government. The objective of this retrospective cohort study was to evaluate graft and patient survival rates in patients who were transplanted from living donors at the Nephrology Unit of the National Hospital of Sri Lanka from January 2005 to January 2011. Data were collected using an interviewer-administered questionnaire and through a review of past medical records. The Kaplan-Meier method was used to determine the survival rate, the log rank test was used to compare survival curves and the Cox proportional hazard model was used for multivariate analysis. Mean follow-up was 26.44±16.6 months. The five-year death-censored graft survival of kidney transplant recipients from living donors in our center was 93.5% and the five-year patient survival was 82.2%, which is comparable with other transplant programs around the world. The number of acute rejection episodes was an independent risk factor for graft survival. Delayed graft function, younger recipient age and unknown cause of end-stage renal disease were found to be risk factors for graft failure but after adjusting for confounding factors, and the difference was not apparent.
慢性肾脏病是斯里兰卡主要的公共卫生问题之一。与透析相比,成功的肾移植可提高患者生存率和生活质量,减轻终末期肾病患者的透析负担,并降低社会和政府的医疗保健成本。这项回顾性队列研究的目的是评估2005年1月至2011年1月在斯里兰卡国家医院肾脏病科接受活体供肾移植患者的移植物和患者生存率。通过访谈式问卷并查阅既往病历收集数据。采用Kaplan-Meier法确定生存率,对数秩检验用于比较生存曲线,Cox比例风险模型用于多变量分析。平均随访时间为26.44±16.6个月。我们中心活体供肾移植受者的五年死亡删失移植物生存率为93.5%,五年患者生存率为82.2%,与世界其他移植项目相当。急性排斥反应次数是移植物生存的独立危险因素。移植肾功能延迟、受者年龄较小和终末期肾病病因不明被发现是移植物失败的危险因素,但在调整混杂因素后,差异不明显。