Fabian June, Maher Heather, Bentley Alison, Gaylard Petra, Crymble Kim, Rossi Belinda, Aucamp Lou, Gottlich Errol, Loveland Jerome, Botha J Rene, Botha Jean, Britz Russell
Wits Donald Gordon Medical Centre, Johannesburg, South Africa; Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
S Afr Med J. 2016 Jan 7;106(2):172-6. doi: 10.7196/SAMJ.2016.v106i2.10190.
It is important for centres participating in transplantation in South Africa (SA) to audit their outcomes. Wits Donald Gordon Medical Centre (WDGMC), Johannesburg, SA, opened a transplant unit in 2004. The first 10 years of kidney and pancreas transplantation were reviewed to determine outcomes in respect of recipient and graft survival.
A retrospective review was conducted of all kidney-alone and simultaneous kidney-pancreas (SKP) transplants performed at WDGMC from 1 January 2004 to 31 December 2013, with follow-up to 31 December 2014 to ensure at least 1 year of survival data. Information was accessed using the transplant registers and clinical records in the transplant clinic at WDGMC. The Kaplan-Meier method was used to estimate 1-, 5- and 10-year recipient and graft survival rates for primary (first graft) kidney-alone and SKP transplants.
The overall 10-year recipient and graft survival rates were 80.4% and 66.8%, respectively, for kidney-alone transplantation. In the kidney-alone group, children tended towards better recipient and graft survival compared with adults, but this was not statistically significant. In adults, recipient survival was significantly better for living than deceased donor type. Recipient and graft survival were significantly lower in black Africans than in the white (largest proportion in the sample) reference group. For SKP transplants, the 10-year recipient survival rate was 84.7%, while kidney and pancreas graft survival rates were 73.1% and 43.2%, respectively.
Outcomes of the first 10 years of kidney and pancreas transplantation at WDGMC compare favourably with local and international survival data.
对于南非参与移植手术的中心而言，审核其手术结果至关重要。位于南非约翰内斯堡的威特沃特斯兰德大学唐纳德·戈登医疗中心（WDGMC）于2004年开设了一个移植单元。回顾了肾脏和胰腺移植的头10年，以确定受者和移植物存活方面的结果。
对2004年1月1日至2013年12月31日在WDGMC进行的所有单纯肾移植和同期肾胰联合移植（SKP）进行回顾性研究，并随访至2014年12月31日，以确保至少有1年的存活数据。通过WDGMC移植诊所的移植登记册和临床记录获取信息。采用Kaplan-Meier方法估计单纯肾移植和SKP移植的原发性（首次移植）受者及移植物1年、5年和10年的存活率。
单纯肾移植的10年总体受者和移植物存活率分别为80.4%和66.8%。在单纯肾移植组中，儿童的受者和移植物存活率往往高于成人，但差异无统计学意义。在成人中，活体供肾受者的存活率明显高于尸体供肾者。非洲黑人的受者和移植物存活率显著低于白人（样本中比例最大）参照组。对于SKP移植，10年受者存活率为84.7%，而肾脏和胰腺移植物存活率分别为73.1%和43.2%。
WDGMC肾脏和胰腺移植头10年的结果与本地和国际存活数据相比具有优势。
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