糖尿病肾病所致终末期肾病患者ABO血型不相容肾移植的临床结局
Clinical Outcomes of ABO-Incompatible Kidney Transplantation in Patients with End-Stage Kidney Disease due to Diabetes Nephropathy.
作者信息
Uchida Junji, Kosoku Akihiro, Kabei Kazuya, Nishide Shunji, Shimada Hisao, Iwai Tomoaki, Kuwabara Nobuyuki, Naganuma Toshihide, Maeda Keiko, Kumada Norihiko, Takemoto Yoshiaki, Nakatani Tatsuya
机构信息
Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan,
Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan.
出版信息
Urol Int. 2019;102(3):341-347. doi: 10.1159/000496029. Epub 2019 Jan 10.
BACKGROUND
Diabetes nephropathy is one of the most common causes of end-stage kidney disease (ESKD) worldwide. The data are clear that kidney transplantation is superior to remaining on dialysis for patients with diabetes. However, there have been no reports on ABO-incompatible kidney transplantation in patients with ESKD due to diabetes nephropathy.
PATIENTS AND METHODS
We conducted a retrospective, observational study to investigate the clinical outcomes of ABO-incompatible kidney transplantation for patients with pre-existing diabetes nephropathy at our institution from April 2011 to October 2017. A total of 14 recipients were enrolled in this study.
RESULTS
All 14 patients underwent successful kidney transplantation. Both overall patient and graft survival rates were 100, 89.9, and 89.9% at 1, 3, and 5 years, respectively. One patient died 20 months after transplantation with a functioning graft due to pancreas cancer. Two of the 14 patients (14.3%) developed biopsy-proven acute cellular rejection during the follow-up period. The median observation period was 32.0 months (range 5-83 months).
CONCLUSION
ABO-incompatible kidney transplantation may be an acceptable renal replacement therapy for ESKD patients with diabetes.
背景
糖尿病肾病是全球终末期肾病（ESKD）最常见的病因之一。数据表明，对于糖尿病患者，肾移植优于继续接受透析治疗。然而，尚无关于糖尿病肾病所致ESKD患者进行ABO血型不相容肾移植的报道。
患者与方法
我们进行了一项回顾性观察研究，以调查2011年4月至2017年10月期间在我院患有糖尿病肾病的患者接受ABO血型不相容肾移植的临床结局。本研究共纳入14例受者。
结果
所有14例患者均成功进行了肾移植。患者总体生存率和移植物生存率在1年、3年和5年时分别为100%、89.9%和89.9%。1例患者在移植20个月后因胰腺癌死亡，移植物功能良好。14例患者中有2例（14.3%）在随访期间发生经活检证实的急性细胞排斥反应。中位观察期为32.0个月（范围5 - 83个月）。
结论
ABO血型不相容肾移植对于糖尿病所致ESKD患者可能是一种可接受的肾脏替代治疗方法。
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