Takemoto S, Terasaki P I
Clin Transpl. 1988:345-56.
Donor age. 1. Kidneys from older donors led to markedly lower graft survival than kidneys from younger donors. The 1-year first cadaver donor graft survival rates were 80% for recipients receiving kidneys from 16-year-old donors, 70% from 50-year olds and 57% from 65-year-old donors. This means that 1-year graft survival decreased 10% by donor age 50 and 23% by donor age 65. 2. The trend toward lower graft survival with older donors was most noticeable after 1985, suggesting that CsA treatment was primarily responsible for the effect. 3. Twelve percent of kidneys from donors over age 50 never functioned while the nonfunction rate of 17- to 30-year-old donor kidneys was only 2%. Forty-six percent of kidneys from younger donors functioned within 3 days, whereas 26% functioned in 3 days if they came from donors who were older than 50. 4. The tendency to use older donors has gradually increased in the past 10 years. Donors over 50 years of age comprised 5% of the donors in 1978 and rose to 10% by 1987. 5. Transfusions, HLA-B,DR mismatches, and causes of failure were not related to donor age. 6. In transplants performed in the last 10 years, donor age did not play a significant role in either patient or graft survival. Whether or not this will hold true for more recent CsA-treated transplants remains to be seen. Recipient age. 1. The most significant effect of recipient age for patients transplanted since 1983 was on patient survival: it dropped from 100% for 6- to 7-year-old recipients to 86% for 68- to 71-year olds. 2. There is an increased tendency to transplant patients older than 50. The number rose from 14% in 1978 to 25% in 1987. 3. A very strong association was noted between advancing recipient age and corresponding decrease in immunologic failures and increase in nonimmunologic failures. Immunologic responsiveness to allografts decreased with age, though failures from nonimmunologic causes increased with age. 4. Patients with no transfusions had increasingly higher graft survival with age: 63% 1-year graft survival for patients up to 20 years old and 73% for those over 50 which was consistent with the above findings. Transfusions led to 1-year graft survival of about 76% in all groups. Thus, transfusions had less effect in older recipients.(ABSTRACT TRUNCATED AT 400 WORDS)
供体年龄。1. 来自老年供体的肾脏移植后的移植物存活率明显低于年轻供体的肾脏。接受16岁供体肾脏的受者1年首次尸体供体移植物存活率为80%，50岁供体的为70%，65岁供体的为57%。这意味着到供体年龄50岁时1年移植物存活率下降了10%，到供体年龄65岁时下降了23%。2. 1985年后，随着供体年龄增长移植物存活率降低的趋势最为明显，这表明环孢素A（CsA）治疗是造成这种影响的主要原因。3. 50岁以上供体的肾脏中有12%从未发挥功能，而17至30岁供体肾脏的无功能率仅为2%。年轻供体的肾脏中有46%在3天内开始发挥功能，而来自50岁以上供体的肾脏在3天内发挥功能的比例为26%。4. 在过去10年中，使用老年供体的趋势逐渐增加。50岁以上的供体在1978年占供体总数的5%，到1987年升至10%。5. 输血、HLA - B、DR错配以及失败原因与供体年龄无关。6. 在过去10年进行的移植手术中，供体年龄对患者或移植物存活均未起到显著作用。对于最近接受CsA治疗的移植手术是否依然如此还有待观察。受者年龄。1. 自1983年以来接受移植的患者中，受者年龄最显著的影响在于患者存活率：6至7岁受者的存活率为100%，而68至71岁受者的存活率降至86%。2. 移植50岁以上患者的趋势有所增加。这一数字从1978年的14%升至1987年的25%。3. 观察到受者年龄增长与免疫性失败相应减少以及非免疫性失败增加之间存在非常强的关联。对同种异体移植物的免疫反应性随年龄降低，而非免疫性原因导致的失败则随年龄增加。4. 未接受输血的患者移植物存活率随年龄增长越来越高：20岁及以下患者的1年移植物存活率为63%，50岁以上患者为73%，这与上述发现一致。输血导致所有组的1年移植物存活率约为76%。因此，输血对老年受者的影响较小。（摘要截选至400字）
