Department of Urology, Oyokyo Kidney Research Institute, Hirosaki, Japan.
Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan.
Clin Exp Nephrol. 2019 Jun;23(6):807-813. doi: 10.1007/s10157-019-01710-z. Epub 2019 Feb 27.
The impact of distance between donor and recipient hospitals on outcomes in cadaveric kidney transplantations is unknown. We investigated the association between inter-hospital distance and outcomes in cadaveric kidney transplantations in Japan.
We retrospectively analyzed 363 cadaveric kidney transplantations between 2002 and 2017 in Japan. Inter-hospital distance, graft transport time, total ischemic time (TIT), and graft survival were compared between our hospital and national transplantation cohort in Japan. Estimated glomerular filtration rate (eGFR) 1 month and 1 year after transplantation was compared between cadaveric and living-donor kidney transplantations in our hospitals. Additionally, inter-hospital distances among the seven geographical regions in Japan were assessed.
There were 12 and 351 cadaveric kidney transplantations at our hospital and in Japan, respectively. Mean inter-hospital distance at our hospital (217 ± 121 km) was significantly longer than that of the national cohort (53 ± 80 km; P < 0.001). Mean TIT and graft survival for our hospital and national cohort were 539 ± 200 min and 91% and 491 ± 193 min and 81%, respectively. Mean eGFRs 1 year after cadaveric and living-donor transplantations at our hospitals were comparable (47 ± 16 vs. 47 ± 15 mL/min/1.73 m). The comparison among seven regions in Japan indicated a regional difference in inter-hospital distance with an association between area (km) and inter-hospital distance (km).
Despite the longer inter-hospital distance at our hospital, TIT and transplant outcomes were acceptable in our cases. In addition, geographical inequity in graft allocation in Japan was suggested.
供体医院和受体医院之间的距离对尸体肾移植的结果有何影响尚不清楚。我们研究了日本尸体肾移植中供体医院和受体医院之间的距离与结果之间的关系。
我们回顾性分析了 2002 年至 2017 年期间在日本进行的 363 例尸体肾移植。比较了我院与日本全国移植队列之间的供体医院间距离、移植物运输时间、总缺血时间（TIT）和移植物存活率。比较了我院尸体和活体供肾移植后 1 个月和 1 年的估算肾小球滤过率（eGFR）。还评估了日本七个地理区域之间的供体医院间距离。
我院有 12 例，日本有 351 例尸体肾移植。我院平均供体医院间距离（217 ± 121 公里）明显长于全国队列（53 ± 80 公里；P < 0.001）。我院和全国队列的平均 TIT 和移植物存活率分别为 539 ± 200 分钟和 91%，以及 491 ± 193 分钟和 81%。我院尸体和活体供肾移植后 1 年的平均 eGFR 相当（47 ± 16 与 47 ± 15 mL/min/1.73 m）。日本七个地区的比较表明供体医院间距离存在区域差异，且与区域面积（公里）与供体医院间距离（公里）之间存在关联。
尽管我院的供体医院间距离较长，但我院的 TIT 和移植结果是可以接受的。此外，日本的供体分配存在地理不平等。
