Choi Seunghyeok, Lee Hanbi, Eum Sang Hun, Min Ji-Won, Yoon Hye Eun, Yang Chul Woo, Chung Byung Ha
Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Transplantation Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Kidney Res Clin Pract. 2024 Sep 11. doi: 10.23876/j.krcp.24.128.
The aim of this study is to investigate the impact of sex on the clinical outcomes of spousal donor kidney transplantation.
We analyzed 456 spousal donor kidney transplantation recipients and categorized them into standard or high immunological risk groups according to panel-reactive antibody ≥50% or less. There were 366 recipients in the standard-risk group and 89 recipients in the high-risk group.
When comparing biopsy-proven allograft rejection within 1 year from kidney transplantation, husband-to-wife recipients showed significantly higher incidence than wife-to-husband recipients in the high-risk group. By contrast, there was no significant difference between wife-to-husband and husband-to-wife recipients in the standard-risk group. Allograft function recovery was better in husband-to-wife recipients than in wife-to-husband recipients in each group, while husband-to-wife recipients in the high-risk group showed a more rapid decline than other recipients. The long-term patient and allograft survival rates showed no difference between husband-to-wife recipients and wife-to-husband recipients within the same groups.
The husband-to-wife recipients with high immunological risk showed a higher risk of biopsy-proven allograft rejection compared to wife-to-husband recipients, so careful monitoring and management may be required.
本研究旨在调查性别对配偶供肾移植临床结局的影响。
我们分析了456例配偶供肾移植受者，并根据群体反应性抗体≥50%或更低将他们分为标准免疫风险组或高免疫风险组。标准风险组有366例受者，高风险组有89例受者。
在比较肾移植后1年内经活检证实的移植肾排斥反应时，高风险组中夫供妻受者的发生率显著高于妻供夫受者。相比之下，标准风险组中妻供夫受者和夫供妻受者之间没有显著差异。每组中夫供妻受者的移植肾功能恢复情况均优于妻供夫受者，而高风险组中的夫供妻受者肾功能下降速度比其他受者更快。同一组内夫供妻受者和妻供夫受者的长期患者及移植肾存活率没有差异。
与妻供夫受者相比，高免疫风险的夫供妻受者经活检证实的移植肾排斥反应风险更高，因此可能需要进行仔细的监测和管理。
