Department of Urology, The Eighth Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China.
Department of Special Operations Medicine, The Sixth Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China.
Ann Transplant. 2024 Oct 8;29:e945065. doi: 10.12659/AOT.945065.
BACKGROUND This study aimed to evaluate the impact of the donor-recipient relationship on the long-term outcomes of living-related kidney transplantation (LRKT), a topic that has been previously underreported. MATERIAL AND METHODS A total of 598 LRKTs performed between 2001 and 2021were analyzed and classified into 5 groups based on the donor-recipient relationship: 228 from mothers (M-to-C), 160 from fathers (F-to-C), 115 from siblings, 55 from spouses, and 40 from offspring. Graft survival, postoperative complications within the first year, serum creatinine (Scr), and hazard ratio (HR) for all-cause graft loss were assessed. RESULTS The overall 1-, 3-, 5-, 7-, and 10-year graft survival rates were 96.0%, 92.4%, 86.4%, 79.9%, and 69.9%, respectively. The graft survival rate in the sibling group was slightly higher than those in the M-to-C and F-to-C groups, and the differences between the groups were insignificant. The survival rates of grafts donated by spouses and offspring were lower than in other groups, and the incidence of graft loss within the first postoperative year was higher in the offspring group. In comparison to the sibling group, spouse and offspring donations increased the graft loss risk (HR, 3.3; 95% CI, 1.6-6.9) and 3.8 (1.7-8.4), respectively, followed by M-to-C and F-to-C donations (HR, 1.9; 95% CI: 1.2-3.4) and 1.8 (1.1-3.1), respectively, which were associated with elevated postoperative Scr levels. CONCLUSIONS Spouse and offspring donations significantly increased the risk of graft loss compared to donations from siblings, followed by M-to-C and F-to-C pairings, which were associated with higher postoperative Scr levels.
本研究旨在评估供受者关系对活体亲属肾移植（LRKT）长期结果的影响，这是一个以前报道较少的话题。
对 2001 年至 2021 年期间进行的 598 例 LRKT 进行分析，并根据供受者关系将其分为 5 组：228 例来自母亲（M-to-C），160 例来自父亲（F-to-C），115 例来自兄弟姐妹，55 例来自配偶，40 例来自子女。评估了移植物存活率、术后 1 年内的并发症、血清肌酐（Scr）和全因移植物丢失的风险比（HR）。
总体 1、3、5、7 和 10 年移植物存活率分别为 96.0%、92.4%、86.4%、79.9%和 69.9%。兄弟姐妹组的移植物存活率略高于 M-to-C 和 F-to-C 组，但组间差异无统计学意义。配偶和子女捐献的移植物存活率低于其他组，且术后 1 年内移植物丢失的发生率在子女组较高。与兄弟姐妹组相比，配偶和子女捐献分别增加了移植物丢失的风险（HR，3.3；95%CI，1.6-6.9）和 3.8（1.7-8.4），其次是 M-to-C 和 F-to-C 捐献（HR，1.9；95%CI：1.2-3.4）和 1.8（1.1-3.1），这些与术后 Scr 水平升高有关。
与来自兄弟姐妹的捐献相比，配偶和子女的捐献显著增加了移植物丢失的风险，其次是 M-to-C 和 F-to-C 配对，这与术后 Scr 水平升高有关。
