Simforoosh Nasser, Basiri Abbas, Tabibi Ali, Nadjafi-Semnani Mohammad
From the Department of Urology and Kidney Transplantation, Shahid Labbafinejad Hospital, Urology Nephrology Research Center, Shahid Beheshti Medical University, Tehran, Iran.
Exp Clin Transplant. 2019 Jan;17(Suppl 1):250-253. doi: 10.6002/ect.MESOT2018.P110.
It is usually assumed that an active livingdonor transplant program inhibits the growth of a deceased-donor kidney transplant program. In our 33-year experience, we found the contrary to be true.
From 1984 until 2017, we performed a total of 4966 kidney transplant procedures. All cases were registered through the Collaborating Transplant Study (Heidelberg, Germany).
During the first 16 years, only living-donor kidney transplant procedures were done. Our first unrelated living-donor kidney transplant procedure was in 1986 and involved a wife to husband donation. This breakthrough in our country was the first in our unrelated living-donor kidney transplant program. In 2000, the Iranian Parliament passed the deceased-donor transplant act, and we have started deceased-donor kidney transplants since then. Despite a jam-packed living-donor kidney transplant program, our deceased-donor kidney transplant program has grown steadily since then and now comprises more than 50% of our kidney transplant procedures. When we compared the outcome of these programs, the 5-year survival from Collaborating Transplant Study report of 3527 cases of 114 living-related donor procedures was 90%. The 5-year survival rates for living unrelated-donor (n = 2689) and deceased-donor (n = 724) transplant procedures were 88% and 83%, respectively (P = .001).
Our data showed that deceased-donor kidney transplant procedures have steadily increased despite an active unrelated living-donor kidney transplant program. Wait lists for kidney transplant can be significantly reduced by following our model, both in developed and in developing countries.
通常认为活跃的活体供肾移植项目会抑制尸体供肾移植项目的发展。但根据我们33年的经验，情况恰恰相反。
1984年至2017年，我们共进行了4966例肾移植手术。所有病例均通过合作移植研究（德国海德堡）进行登记。
在最初的16年里，仅开展了活体供肾移植手术。我们的首例非亲属活体供肾移植手术于1986年进行，是妻子捐肾给丈夫。这一国内的突破是我们非亲属活体供肾移植项目中的首例。2000年，伊朗议会通过了尸体供肾移植法案，自那时起我们开始了尸体供肾移植。尽管活体供肾移植项目十分繁忙，但自那时起我们的尸体供肾移植项目仍稳步发展，目前已占我们肾移植手术的50%以上。当我们比较这些项目的结果时，合作移植研究报告中114例亲属活体供肾手术的3527例病例的5年生存率为90%。非亲属活体供肾（n = 2689）和尸体供肾（n = 724）移植手术的5年生存率分别为88%和83%（P = 0.001）。
我们的数据表明，尽管有活跃的非亲属活体供肾移植项目，尸体供肾移植手术仍在稳步增加。遵循我们的模式，发达国家和发展中国家的肾移植等待名单都可显著减少。
