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活体供肾肾移植的临床结果:拉丁美洲单中心经验

Clinical Outcomes in Living Donor Kidney Transplantation: A Single Center Experience in Latin America.

作者信息

Baez-Suarez Yenny, Garcia-Lopez Andrea, Patino-Jaramillo Nasly, Giron-Luque Fernando

机构信息

Department of Transplant Surgery, Colombiana de Trasplantes, Bogotá, Colombia.

Department of Transplant Research, Colombiana de Trasplantes, Bogotá, Colombia.

出版信息

Transplant Proc. 2023 Jul-Aug;55(6):1477-1483. doi: 10.1016/j.transproceed.2022.11.014. Epub 2023 Jan 21.

Abstract

BACKGROUND

In Latin America, few reports are available about the clinical outcomes of living donor kidney transplants (LDKT). We aim to evaluate the main clinical outcomes for LDKT patients in a single center's experience.

METHODS

We retrospectively evaluated 530 LDKT patients who underwent transplantation from August 2008 to December 2020 at Colombiana de Trasplantes. Graft survival censored for death and patient survival were determined up to 5 years post-transplantation by the Kaplan-Meier method. Vascular and urinary complications, readmission, and reintervention rates were documented.

RESULTS

A total of 530 LDKT patients were analyzed. Most of the recipients were men (56%). There were 123 patients (23.2%) with a preemptive transplant. Panel reactive antibody type I and II had higher immunologic risk (>20%) in 15.9% of the patients. The donor mean age was 37.8 ± 11.5 years. Most of the donors were women (52.6%) and related to the recipient (69.1%). Multivariate analysis identified panel reactive antibody type II (P = 0.003), female donor (P = 0.001), surgical reintervention at 30 days post-transplantation (P < .01), and delayed graft function (P < .01) as risk factors for graft loss. The graft survival death-censored rates were 93.7% and 89% at 1 and 5 years, respectively. Patient survival rates were 97.0% and 94.1% at 1 and 5 years after transplantation, respectively.

CONCLUSIONS

The long-term graft and patient survival rates in our center are comparable to previous reports from other leading centers. The clinical outcomes from a medium-sized center can be noteworthy, although not entirely new.

摘要

背景

在拉丁美洲,关于活体供肾移植(LDKT)临床结果的报道较少。我们旨在评估单中心经验中LDKT患者的主要临床结果。

方法

我们回顾性评估了2008年8月至2020年12月在哥伦比亚移植中心接受移植的530例LDKT患者。采用Kaplan-Meier法确定移植后5年内的死亡截尾移植物存活率和患者存活率。记录血管和泌尿系统并发症、再入院率和再次干预率。

结果

共分析了530例LDKT患者。大多数受者为男性(56%)。有123例患者(23.2%)接受了抢先移植。15.9%的患者I类和II类群体反应性抗体具有较高的免疫风险(>20%)。供者平均年龄为37.8±11.5岁。大多数供者为女性(52.6%),且与受者有亲属关系(69.1%)。多因素分析确定II类群体反应性抗体(P = 0.003)、女性供者(P = 0.001)、移植后30天的手术再次干预(P < 0.01)和移植肾功能延迟(P < 0.01)为移植物丢失的危险因素。1年和5年的死亡截尾移植物存活率分别为93.7%和89%。移植后1年和5年的患者存活率分别为97.0%和94.1%。

结论

我们中心的长期移植物和患者存活率与其他领先中心的既往报道相当。一个中等规模中心的临床结果值得关注,尽管并非全新。

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