Skrabaka Damian, Franczyk Szymon, Kolonko Aureliusz, Sekta Sylwia, Czerwiński Jarosław, Owczarek Aleksander, Valenta Zdenek, Król Robert, Więcek Andrzej, Ziaja Jacek
Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Poland.
Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Poland.
Transplant Proc. 2020 Oct;52(8):2376-2381. doi: 10.1016/j.transproceed.2020.01.093. Epub 2020 Apr 23.
As the population ages, the number of people suffering from cardiovascular diseases (CVD) and diabetes mellitus (DM) increases. The coexistence of these diseases can affect the results of kidney transplantation (KT) in the elderly. The aim of this study was to analyze surgical and nonsurgical complications in the early period after KT and to identify the factors that influence their development in recipients aged ≥ 60 years compared to younger recipients < 60 years.
One hundred seventy-five recipients of KT ≥ 60 years and 175 recipients of KT < 60 years who received kidneys from the same deceased donor were enrolled into the study. The incidence of surgical and nonsurgical complications, factors that may influence their development, early graft function, and patient and kidney-graft survival were analyzed during a 3-month follow-up period. Donor sources complied with the Helsinki Congress and Istanbul Declaration and organs were not procured from prisoners and individuals who were coerced or paid.
Older recipients were characterized by higher body mass index ± SD (26.1 ± 3.5 vs 24.7 ± 3.4 kg/m) and suffered more often from pretransplant DM (20.6% vs 11.4%) and CVD (34.3% vs 10.3%) and less frequently underwent previous KT (6.3% vs 20.0%). There were no differences between the ≥ 60 year old and < 60 year old groups in reference to surgical (20.6% vs 24%) and nonsurgical complications (28.6% vs 27.4%), early graft function, serum creatinine, and proteinuria. Recipients (95.4% vs 97.1%) and kidney-graft survival (93.1% vs 95.4%) were similar in both groups. The recipient factors that influenced the development of infectious complications were age, dialysis duration, pretransplant DM, and CVD.
Despite higher co-incidence of CVD and DM, the risk of surgical and nonsurgical complications in elderly recipients is comparable to younger recipients in the early period after KT.
随着人口老龄化，患心血管疾病（CVD）和糖尿病（DM）的人数增加。这些疾病的共存会影响老年患者肾移植（KT）的结果。本研究的目的是分析KT术后早期的手术和非手术并发症，并确定与年龄小于60岁的年轻受者相比，年龄≥60岁的受者中影响并发症发生的因素。
选取175例年龄≥60岁的KT受者和175例年龄<60岁的KT受者，他们接受了来自同一已故供体的肾脏。在3个月的随访期内，分析手术和非手术并发症的发生率、可能影响其发生的因素、早期移植肾功能以及患者和肾移植存活率。供体来源符合赫尔辛基大会和伊斯坦布尔宣言，器官并非取自囚犯以及受到胁迫或有报酬的个人。
老年受者的特点是体重指数±标准差较高（26.1±3.5 vs 24.7±3.4 kg/m），移植前患DM（20.6% vs 11.4%）和CVD（34.3% vs 10.3%）的频率更高，既往接受KT的频率更低（6.3% vs 20.0%）。在手术并发症（20.6% vs 24%）和非手术并发症（28.6% vs 27.4%）、早期移植肾功能、血清肌酐和蛋白尿方面，≥60岁组和<60岁组之间没有差异。两组的受者存活率（95.4% vs 97.1%）和肾移植存活率（93.1% vs 95.4%）相似。影响感染性并发症发生的受者因素包括年龄、透析时间、移植前DM和CVD。
尽管CVD和DM的并发率较高，但老年受者在KT术后早期发生手术和非手术并发症的风险与年轻受者相当。
