Parajuli Sandesh, Garonzik-Wang Jacqueline, Astor Brad C, Aziz Fahad, Garg Neetika, Welch Bridget, Odorico Jon, Mezrich Joshua, Kaufman Dixon, Foley David P, Mandelbrot Didier
Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI.
UW Health Transplant Center, Madison, WI.
Transplant Direct. 2024 Jan 19;10(2):e1575. doi: 10.1097/TXD.0000000000001575. eCollection 2024 Feb.
Kidney transplant outcomes have dramatically improved since the first successful transplant in 1954. In its early years, kidney transplantation was viewed more skeptically. Today it is considered the treatment of choice among patients with end-stage kidney disease.
Our program performed its first kidney transplant in 1966 and recently performed our 12 000th kidney transplant. Here, we review and describe our experience with these 12 000 transplants. Transplant recipients were analyzed by decade of date of transplant: 1966-1975, 1976-1985, 1986-1995, 1996-2005, 2006-2015, and 2016-2022. Death-censored graft failure and mortality were outcomes of interest.
Of 12 000 kidneys, 247 were transplanted from 1966 to 1975, 1147 from 1976 to 1985, 2194 from 1986 to 1995, 3147 from 1996 to 2005, 3046 from 2006 to 2015, and 2219 from 2016 to 2022 compared with 1966-1975, there were statistically significant and progressively lower risks of death-censored graft failure at 1 y, 5 y, and at last follow-up in all subsequent eras. Although mortality at 1 y was lower in all subsequent eras after 1986-1995, there was no difference in mortality at 5 y or the last follow-up between eras.
In this large cohort of 12 000 kidneys from a single center, we observed significant improvement in outcomes over time. Kidney transplantation remains a robust and ever-growing and improving field.
自1954年首次成功进行肾移植以来,肾移植的结果有了显著改善。在早期,肾移植受到更多质疑。如今,它被视为终末期肾病患者的首选治疗方法。
我们的项目于1966年进行了首例肾移植,最近完成了第12000例肾移植。在此,我们回顾并描述了这12000例移植的经验。根据移植日期的十年对移植受者进行分析:1966 - 1975年、1976 - 1985年、1986 - 1995年、1996 - 2005年、2006 - 2015年和2016 - 2022年。以死亡为截尾的移植物失败和死亡率是关注的结果。
在12000例肾移植中,1966年至1975年移植了247例,1976年至1985年移植了1147例,1986年至1995年移植了2194例,1996年至2005年移植了3147例,2006年至2015年移植了3046例,2016年至2022年移植了2219例。与1966 - 1975年相比,在所有后续时期,1年、5年及最后随访时以死亡为截尾的移植物失败风险在统计学上均显著降低且呈逐渐下降趋势。尽管1986 - 1995年后的所有后续时期1年死亡率较低,但各时期之间5年或最后随访时的死亡率没有差异。
在这个来自单一中心的12000例肾移植的大型队列中,我们观察到随着时间推移结果有显著改善。肾移植仍然是一个强大且不断发展和进步的领域。