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首例300例肾移植的临床结局:一项单中心回顾性队列研究。

Clinical outcomes of the first 300 cases of kidney transplantation: a single-center retrospective cohort study.

作者信息

Koh Hyoung Won, Koo Kyunglim, Shin Chang Sik, Park Hyung Sub, Jeong Jong Cheol, Kim Sejoong, Chae Dong Wan, Oh Jong Jin, Byun Seok-Soo, Lee Taeseung

机构信息

Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.

Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Korean J Transplant. 2020 Sep 30;34(3):154-166. doi: 10.4285/kjt.2020.34.3.154.

Abstract

BACKGROUND

Kidney transplantation (KT) is regarded as the most effective treatment for end-stage renal disease. The annual number of KT cases in South Korea has increased rapidly as more centers are implementing a transplantation program. The objective of this study was to determine clinical outcomes of the first 300 consecutive cases of KT in a single center.

METHODS

Clinical data of 300 cases of KT at Seoul National University Bundang Hospital from January 2004 to March 2018 were obtained from a prospectively collected database and retrospectively reviewed.

RESULTS

The mean age of patients was 47.7±12.9 years, and 59% of patients were male. There were 225 living donors and 75 deceased donors. A total of 42 cases were from ABO-incompatible donors. During a mean follow-up of 68.6±43.5 months, 38 patients (12.7%) experienced rejection. The most common cause was acute T-cell mediated rejection (9.0%). Eighteen patients experienced graft loss. One-year and 5-year death-censored graft survival rates were 99% and 96.6%, respectively. One-year and 5-year patient survival rates were 98.3% and 96.6%, respectively. Multivariate analysis revealed that graft weight-to-recipient weight ratio and rejection were significant factors affecting graft survival.

CONCLUSIONS

This single-center review demonstrates clinical outcomes comparable to other major centers. Such good outcomes were obtained by good patient selection, dedicated transplant physicians, and adequate use of immunosuppressive therapy.

摘要

背景

肾移植(KT)被视为终末期肾病最有效的治疗方法。随着越来越多的中心开展移植项目,韩国每年的KT病例数迅速增加。本研究的目的是确定单中心连续300例KT病例的临床结局。

方法

从前瞻性收集的数据库中获取并回顾性分析了2004年1月至2018年3月在首尔国立大学盆唐医院进行的300例KT病例的临床资料。

结果

患者的平均年龄为47.7±12.9岁,59%为男性。有225例活体供体和75例尸体供体。共有42例来自ABO血型不相合供体。在平均68.6±43.5个月的随访期间,38例患者(12.7%)发生排斥反应。最常见的原因是急性T细胞介导的排斥反应(9.0%)。18例患者出现移植物丢失。1年和5年的死亡截尾移植物存活率分别为99%和96.6%。1年和5年的患者存活率分别为98.3%和96.6%。多因素分析显示,移植物重量与受者体重之比和排斥反应是影响移植物存活的重要因素。

结论

这项单中心综述显示其临床结局与其他主要中心相当。通过良好的患者选择、专业的移植医生和充分使用免疫抑制治疗获得了如此良好的结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e18/9187040/e9bd5707a88b/KJT-34-3-154-f1.jpg

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