老年与年轻受者胰腺移植的结局：一项对比分析。

Outcomes of pancreas transplantation in older versus younger recipients: a comparative analysis.

作者信息

Matsushima Hajime, Ito Taihei, Aida Naohiro, Kurihara Kei, Tomimaru Yoshito, Ito Toshinori, Kenmochi Takashi

机构信息

Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukakecho, Toyoake-shi, Aichi, 470-1192, Japan.

Japan Society for Pancreas and Islet Transplantation, The Japan Pancreas Transplant Registry, Osaka, Japan.

出版信息

Surg Today. 2021 Oct;51(10):1655-1664. doi: 10.1007/s00595-021-02284-8. Epub 2021 Apr 12.

DOI:10.1007/s00595-021-02284-8

PMID:33844061

Abstract

PURPOSE

The feasibility of pancreas transplantation (PT) in older recipients remains a matter of debate. We examined the influence of recipient age on PT outcomes and identified the prognostic factors for older recipients.

METHODS

We compared the outcomes of PT in recipients aged < 50 years (younger group; n = 285) with those in recipients aged ≥ 50 years (older group; n = 94). Prognostic factors in the older group were analyzed by a logistic regression model and the influence of recipient age on survival outcomes were analyzed using propensity score matching.

RESULTS

The patient survival rate was significantly worse in the older group (P < 0.001). Patient death from infection or/and multiple organ failure or cardiac/cerebrovascular events was also more frequent in the older group than in the younger group (P = 0.012 and P = 0.045, respectively). A longer duration of diabetes was an independent risk factor of 1-year mortality in the older group. In a propensity score-matched comparison, the older recipients (n = 77) had significantly poorer survival than the younger recipients (n = 77) (P = 0.026).

CONCLUSIONS

PT should be considered with appropriate caution, especially for older recipients with a long duration of diabetes.

摘要

目的

胰腺移植（PT）在老年受者中的可行性仍存在争议。我们研究了受者年龄对PT结果的影响，并确定了老年受者的预后因素。

方法

我们比较了年龄＜50岁的受者（年轻组；n = 285）与年龄≥50岁的受者（老年组；n = 94）的PT结果。通过逻辑回归模型分析老年组的预后因素，并使用倾向评分匹配分析受者年龄对生存结果的影响。

结果

老年组的患者生存率明显较差（P＜0.001）。老年组因感染或/和多器官衰竭或心脏/脑血管事件导致的患者死亡也比年轻组更频繁（分别为P = 0.012和P = 0.045）。糖尿病病程较长是老年组1年死亡率的独立危险因素。在倾向评分匹配比较中，老年受者（n = 77）的生存率明显低于年轻受者（n = 77）（P = 0.026）。