Zhu Youhua, Zhang Lei, Min Zhilian, He Changmin
Clin Transpl. 2014:77-81.
Between June 1978 and June 2014, 4,199 kidney transplants were performed at the Transplantation Center of PLA, Changzheng Hospital, Second Military Medical University. In our initial practice period (1978-1985), graft and patient survivals were 48.2% and 56.5%, 27.3% and 31.7%, 22.5% and 24.4%, 20.1% and 23.2%, and 16.5% and 20.8%, at 1, 5, 10, 15, and 20 years, respectively. These results improved tremendously after cyclosporine A (1986-1998) was used at our center. The rates of 1-, 5-, 10-, 15-, and 20-year graft and patient survival were 84.3% and 88.5%, 72.3% and 76.7%, 60.4% and 65.4%, 55.1% and 58.2%, and 49.0% and 51.8%, respectively. Tacrolimus (1999-2014) further increased graft survival to 95.1%, 84.4%, 77.1%, and 70.9%, and patient survival to 98.3%, 90.4%, 80.7%, and 73.4%, at 1, 5, 10, and 15 years, respectively. Multivariate Cox analysis suggested that transplant year, delayed graft function, rejection, immunosuppressive regimen, and original disease were independent predictors of graft survival and that poor HLA matching with 5-6 mismatches had an adverse effect on graft survival compared with 1-2 mismatches. The major causes of patient death included infection (38.1%), cardio-cerebral accident (30.2%), and malignancy (16.3%). As one of the pioneer transplant centers in China, our greatest contribution to organ transplantation in China is our self-developed organ preservation solution (HC-A), which has been used in more than 100,000 grafts and for more than 30 years.
1978年6月至2014年6月期间，第二军医大学长征医院解放军器官移植中心共进行了4199例肾移植手术。在我们最初的实践阶段（1978 - 1985年），1年、5年、10年、15年和20年的移植肾和患者生存率分别为48.2%和56.5%、27.3%和31.7%、22.5%和24.4%、20.1%和23.2%、16.5%和20.8%。自我们中心开始使用环孢素A（1986 - 1998年）后，这些结果有了极大改善。1年、5年、10年、15年和20年的移植肾和患者生存率分别为84.3%和88.5%、72.3%和76.7%、60.4%和65.4%、55.1%和58.2%、49.0%和51.8%。他克莫司（1999 - 2014年）进一步提高了移植肾生存率，1年、5年、10年和15年时分别提高到95.1%、84.4%、77.1%和70.9%，患者生存率分别提高到98.3%、90.4%、80.7%和73.4%。多因素Cox分析表明，移植年份、移植肾功能延迟、排斥反应、免疫抑制方案和原发病是移植肾生存的独立预测因素，与1 - 2个错配相比，5 - 6个错配的不良HLA配型对移植肾生存有不利影响。患者死亡的主要原因包括感染（38.1%）、心脑血管意外（30.2%）和恶性肿瘤（16.3%）。作为中国最早的移植中心之一，我们对中国器官移植的最大贡献是自主研发的器官保存液（HC - A），该保存液已应用于超过10万例移植器官，使用时间超过30年。
