Illesy L, Kovács D Á, Szabó R P, Asztalos L, Nemes B
Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Móricz Zsigmond krt. 22., H-4027 Debrecen, Hungary.
Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Móricz Zsigmond krt. 22., H-4027 Debrecen, Hungary.
Transplant Proc. 2017 Sep;49(7):1522-1525. doi: 10.1016/j.transproceed.2017.06.014.
Kidney transplantation is indicated for end-stage renal disease. Autosomal dominant polycystic kidney disease (ADPKD) causes structural degeneration of the kidney and eventually becomes end-stage renal disease. ADPKD patients usually have several renal and nonrenal complications. We analyzed our kidney transplantation activities between 1991 and 2010 regarding ADPKD. We followed up with patients to December 31, 2016. Data were collected as patient and graft survival rates, the prevalence of polycystic manifestation of the gastrointestinal tract and other organs, and the attendance of urinary tract infection. Among the 734 kidney transplantations, 10.9% (n = 80) had an ADPKD. Four patients (5%) had diverticulum perforation. The prevalence of post-transplantation urinary tract infection was higher in ADPKD patients (55.9%) compared to non-ADPKD patients (44.1%). The 1-, 3-, and 5-year overall survival rates in ADPKD recipients versus non-ADPKD patients are 77.5%, 70.0%, and 67.5% versus 86.4%, 83.0%, and 80.1%, respectively. Patients with ADPKD were transplanted at an elder age compared to others (median: 47.5 years vs. 39.9 years). Female patients had longer graft survival times than males. ADPKD implies multiple cystic degeneration of the kidneys; however, it can cause structural degeneration in other organs. It is typical for ADPKD patients to have an acute abdominal-like syndrome. Immunosuppressive drugs can hide the clinical picture, which makes early diagnosis difficult.
肾移植适用于终末期肾病。常染色体显性多囊肾病（ADPKD）会导致肾脏结构退变，最终发展为终末期肾病。ADPKD患者通常有多种肾脏及非肾脏并发症。我们分析了1991年至2010年间我们针对ADPKD患者的肾移植活动。对患者随访至2016年12月31日。收集的数据包括患者和移植物存活率、胃肠道及其他器官多囊表现的患病率以及尿路感染的发生率。在734例肾移植中，10.9%（n = 80）为ADPKD患者。4例（5%）发生憩室穿孔。ADPKD患者移植后尿路感染的发生率（55.9%）高于非ADPKD患者（44.1%）。ADPKD受者与非ADPKD患者的1年、3年和5年总生存率分别为77.5%、70.0%和67.5%，而后者分别为86.4%、83.0%和80.1%。与其他患者相比，ADPKD患者接受移植时年龄较大（中位数：47.5岁对39.9岁）。女性患者的移植物存活时间长于男性。ADPKD意味着肾脏的多发囊性退变；然而，它也可导致其他器官的结构退变。ADPKD患者出现急性腹痛样综合征很常见。免疫抑制药物会掩盖临床表现，这使得早期诊断困难。
