Abderrahim Ezzedine, Zammouri Asma, Bacha Mohamed Mongi, Ounissi Mondher, Gargah Tahar, Hedri Hafedh, Ben Slama Riadh, Bardi Rafika, Chebil Mohamed, Ben Abdallah Taieb
Department of Nephrology and Internal Medicine, University Tunis El Manar, Charles Nicolle Hospital, Tunis, Tunisia.
Exp Clin Transplant. 2017 Feb;15(Suppl 1):84-89. doi: 10.6002/ect.mesot2016.O66.
The aim of this study was to report the results of 30 years of experience at the first kidney transplant center in Tunisia.
All kidney transplants performed at the center between June 1986 and June 2016 were included. The study period was divided into 3 decades. Recipient and donor data and follow-up information were obtained from a local database and patient medical records. Comparative analyses were performed using the t test for continuous variables and the Χ² test for qualitative variables. Patient and graft survival rates were calculated according to the actuarial method, and comparison of survival curves was performed according to the logrank test.
The mean age of recipients was 32.7 ± 11.5 years (range, 6-65 y) with a gender ratio of 2.2. Duration of prekidney transplant dialysis varied from 2 months to 20 years (median, 27.5 mo); 1.7% of patients underwent transplant preemptively. Kidneys were recovered from deceased donors in 21.2% of cases and from living donors in 78.8%. The proportion of deceased donors dropped from 27.4% during the period 2006-2010 to 12.9% during the period 2011-2015 (P < .04). Patient survival rates at 1, 5, 10, 15, and 20 years were 96%, 89.3%, 79.5%, 71.1%, and 65.4%. Graft survival rates were 95%, 86.5%, 76.2%, 66.3%, and 57.2%. The annual graft loss was 2.9%, with a mortality rate of 2.4% and without significant differences between patients receiving deceased-donor and living-donor organs.
Kidney transplant activity remains suboptimal in our country. The reduction in deceased-donor organs could be related to the political transformations facing our country with their resulting social and economic consequences. Efforts should be made to increase governmental resources and to improve both public awareness of organ donation and the motivation of transplant teams.
本研究旨在报告突尼斯首个肾脏移植中心30年的经验结果。
纳入1986年6月至2016年6月期间在该中心进行的所有肾脏移植手术。研究期分为3个十年。从当地数据库和患者病历中获取受者和供者数据以及随访信息。对连续变量采用t检验，对定性变量采用χ²检验进行比较分析。根据精算方法计算患者和移植物存活率，并根据对数秩检验对生存曲线进行比较。
受者的平均年龄为32.7±11.5岁（范围6 - 65岁），性别比为2.2。肾移植前透析时间从2个月至20年不等（中位数为27.5个月）；1.7%的患者接受了抢先移植。21.2%的病例肾脏来自已故供者，78.8%来自活体供者。已故供者的比例从2006 - 2010年期间的27.4%降至2011 - 2015年期间的12.9%（P < 0.04）。1年、5年、10年、15年和20年的患者存活率分别为96%、89.3%、79.5%、71.1%和65.4%。移植物存活率分别为95%、86.5%、76.2%、66.3%和57.2%。年移植物丢失率为2.9%，死亡率为2.4%，接受已故供者器官和活体供者器官的患者之间无显著差异。
我国肾脏移植活动仍未达到最佳状态。已故供者器官数量的减少可能与我国面临的政治变革及其带来的社会和经济后果有关。应努力增加政府资源，提高公众对器官捐赠的认识以及移植团队的积极性。
