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爱尔兰肾移植患者短期、中期和长期移植物存活率的逐步改善——一项回顾性研究。

Progressive improvement in short-, medium- and long-term graft survival in kidney transplantation patients in Ireland - a retrospective study.

机构信息

National Kidney Transplant Service, Department of Nephrology and Kidney Transplantation, Beaumont Hospital, Dublin, Ireland.

Department of Transplant Urology, Beaumont Hospital, Dublin, Ireland.

出版信息

Transpl Int. 2019 Sep;32(9):974-984. doi: 10.1111/tri.13470. Epub 2019 Aug 14.

Abstract

It is often quoted that while short-term graft survival in kidney transplantation has improved in recent years, it has not translated into a commensurate improvement in long-term graft survival. We considered whether this was true of the entire experience of the national kidney transplant program in Ireland. A retrospective analysis of the National Kidney Transplant Service (NKTS) database was undertaken to investigate patient and graft survival for all adult first deceased donor kidney transplant recipients in Ireland, 1971-2015. Three thousand two hundred and sixty recipients were included in this study. Kaplan-Meier methods were used to estimate survival at each time period post transplant for the various eras of transplantation. Uncensored graft survival has improved over the course of the program in Ireland at various time points despite risk factors for graft failure progressively increasing over successive eras. For example the graft survival at 15 years post transplant has increased from 10% in 1971-1975 to 45% by 1996-2000. Ireland has experienced a progressive improvement in long-term graft survival following kidney transplantation. Whether these trends are attributable to biological or nonbiological factors is unclear but likely involves a combination of both.

摘要

人们常说,尽管近年来肾移植的短期移植物存活率有所提高,但这并没有转化为长期移植物存活率的相应提高。我们考虑了这种情况是否适用于爱尔兰全国肾脏移植计划的全部经验。对国家肾脏移植服务(NKTS)数据库进行了回顾性分析,以调查 1971 年至 2015 年间爱尔兰所有成年首次已故供体肾移植受者的患者和移植物存活率。本研究共纳入 3260 名受者。在移植的各个时期,使用 Kaplan-Meier 方法估计移植后每个时间点的存活率。尽管随着连续时代的发展,移植物衰竭的风险因素逐渐增加,但在爱尔兰,该计划的各个时间点的未删失移植物存活率都有所提高。例如,1971-1975 年,移植后 15 年的移植物存活率从 10%增加到 1996-2000 年的 45%。爱尔兰在肾移植后经历了长期移植物存活率的逐步提高。这些趋势是否归因于生物学或非生物学因素尚不清楚,但可能涉及两者的结合。

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