Cecka J M, Terasaki P I
Department of Surgery, University of California, Los Angeles 90024.
Transplantation. 1987 Dec;44(6):792-5. doi: 10.1097/00007890-198712000-00014.
Patients who have lost a transplanted kidney are widely recognized as high-risk patients for retransplantation. We have found a profound difference in cadaver kidney regraft survival associated with the age and sex of the donor. Kidneys from male cadaver donors yielded significantly higher graft survival rates than kidneys from female donors. The difference in graft survival at one year was 7% for all first transplants (n = 2974), 14% if the recipient was sensitized, and 18% in 688 patients being regrafted. The difference was even more striking in regraft recipients of kidneys from young male donors (72% one-year graft survival) as compared with recipients of kidneys from older female donors (44% one-year graft survival). The donor age and sex effects correlated well with the cause of donor death. Young male donors accounted for 59% of trauma deaths whereas older female donors made up only 7%. Nontrauma donors, on the other hand, were 38% older female and 14% younger male. The survival of trauma-death donor kidneys in regrafted patients was 69% at one year and 37% for nontrauma donor kidneys, a 32% difference (P less than 0.001). These results indicate that regraft survival could be significantly increased through the use of cadaver kidneys from trauma death donors.
失去移植肾的患者被广泛认为是再次移植的高危患者。我们发现，与供者的年龄和性别相关的尸体肾再次移植存活率存在显著差异。男性尸体供者的肾移植存活率明显高于女性供者的肾。所有首次移植（n = 2974）一年时的移植存活率差异为7%，受者致敏时为14%，在688例再次移植患者中为18%。与老年女性供者肾的受者（一年移植存活率44%）相比，年轻男性供者肾的再次移植受者的差异更为显著（一年移植存活率72%）。供者年龄和性别的影响与供者死亡原因密切相关。年轻男性供者占创伤死亡供者的59%，而老年女性供者仅占7%。另一方面，非创伤性供者中，老年女性占38%，年轻男性占14%。再次移植患者中，创伤死亡供者肾的一年存活率为69%，非创伤性供者肾为37%，相差32%（P小于0.001）。这些结果表明，使用创伤死亡供者的尸体肾可显著提高再次移植的存活率。
