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确定首次肾移植的生存预测因素:一项回顾性队列研究。

Identify Survival Predictors of the First Kidney Transplantation: A Retrospective Cohort Study.

作者信息

Soltanian Ali-Reza, Mahjub Hossein, Taghizadeeh-Afshari Ali, Gholami Gholamreza, Sayyadi Hojjat

机构信息

Modeling of Noncommunicable Disease Research Center and Dept. of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.

Research Center for Health Sciences and Dept. of Biostatistics & Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.

出版信息

Iran J Public Health. 2015 May;44(5):683-9.

Abstract

BACKGROUND

The first kidney transplant survival is very important. We know that short-term survival of kidney transplantation is improved over the past two decades in Iran; however, no information is available on long-term survival and predictors. This study explored factors influencing long-term renal transplant survival at northwest of Iran.

METHODS

In this single-center, study, survival rates and half-life of 201 the first kidney transplants between 1999 and 2008 were measured by a historical-cohort study in Imam Khomeini Hospital in Urmia, Iran. The log-rank test and Cox-regression model were used to compare survival curves and determine factor affecting graft survival time, respectively.

RESULTS

First graft survival from one, five, and 10 years was 96%, 89%, and 46%, respectively. Mean±se and median±se of first graft survival time was 3061±105.01 day (95% CI: 2855.47-3267.11 day) and 3411±282.1 day (95%CI: 2858.08-3963.92), respectively. Predictors of first graft rejection were recipient age (P=0.001), LDL cholesterol (P=0.008), immunosuppressive drugs (P=0.047), serum creatinine three and six months (P=0.042 and 0.001, respectively) and related donor family (P=0.037).

CONCLUSION

Patients with first graft transplantation had a moderate long-term survival. The study showed that small age at transplant, low LDL cholesterol before transplant, and relative to donor, could be decrease the risk graft loss.

摘要

背景

首次肾移植的存活情况非常重要。我们知道,在过去二十年里,伊朗肾移植的短期存活率有所提高;然而,关于长期存活率及预测因素尚无相关信息。本研究探讨了影响伊朗西北部肾移植长期存活的因素。

方法

在这项单中心研究中,通过对伊朗乌尔米亚伊玛目霍梅尼医院1999年至2008年间的201例首次肾移植进行历史性队列研究,测量其存活率和半衰期。分别使用对数秩检验和Cox回归模型比较生存曲线并确定影响移植物存活时间的因素。

结果

首次移植后1年、5年和10年的移植物存活率分别为96%、89%和46%。首次移植存活时间的均值±标准误和中位数±标准误分别为3061±105.01天(95%置信区间:2855.47 - 3267.11天)和3411±282.1天(95%置信区间:2858.08 - 3963.92)。首次移植排斥反应的预测因素包括受者年龄(P = 0.001)、低密度脂蛋白胆固醇(P = 0.008)、免疫抑制药物(P = 0.047)、术后3个月和6个月的血清肌酐水平(分别为P = 0.042和0.001)以及亲属供体(P = 0.037)。

结论

首次接受移植的患者长期存活率中等。该研究表明,移植时年龄较小、移植前低密度脂蛋白胆固醇水平较低以及亲属供体可降低移植物丢失风险。

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