Ko K, Kim Y H, Kim M H, Jun K W, Hwang J K, Kim S D, Park S C, Kim J I, Moon I S
Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Transplant Proc. 2017 Jun;49(5):982-986. doi: 10.1016/j.transproceed.2017.03.058.
Our objective was to investigate the effects of age on patient and graft survival in expanded criteria donor (ECD) renal transplantation.
Between February 2000 and December 2015, we analyzed 405 deceased donor renal transplants, including 128 grafts (31.9%) from ECDs. Based on recipient age and ECD criteria classification, the recipients were divided into four groups: Group I, non-ECD to recipient age <50 years; Group II, non-ECD to recipient age ≥50 years; Group III, ECD to recipient age <50 years; and Group IV, ECD to recipient age ≥50 years.
Among the four groups, there were significant differences in baseline characteristics (age, body mass index [BMI], cause of end-stage renal disease [ESRD], number of kidney transplantations, and use of induction agent). The mean modification of diet in renal disease (MDRD) glomerular filtration rate (GFR) level at 1 month, 6 months, 1 year, 3 years, and 5 years after transplantation was significantly lower in patients with ECDs but MDRD GFR level at 7, 9, and 10 years did not differ significantly (P = .183, .041, and .388, respectively). There were no significant differences in graft survival (P = .400) and patient survival (P = .147).
Our result shows that, regardless of recipient age, kidney transplants donated by deceased ECDs have similar graft and patient survival.
我们的目标是研究年龄对扩大标准供体（ECD）肾移植中患者和移植物存活的影响。
在2000年2月至2015年12月期间，我们分析了405例尸体供肾移植，其中包括128例（31.9%）来自ECD的移植物。根据受者年龄和ECD标准分类，将受者分为四组：第一组，非ECD且受者年龄<50岁；第二组，非ECD且受者年龄≥50岁；第三组，ECD且受者年龄<50岁；第四组，ECD且受者年龄≥50岁。
在四组中，基线特征（年龄、体重指数[BMI]、终末期肾病[ESRD]病因、肾移植次数和诱导剂使用情况）存在显著差异。移植后1个月、6个月、1年、3年和5年时，ECD患者的平均肾脏病饮食改良（MDRD）肾小球滤过率（GFR）水平显著较低，但7年、9年和10年时的MDRD GFR水平无显著差异（P分别为0.183、0.041和0.388）。移植物存活率（P = 0.400）和患者存活率（P = 0.147）无显著差异。
我们的结果表明，无论受者年龄如何，由已故ECD捐赠的肾移植具有相似的移植物和患者存活率。
