Salvatierra O, Amend W, Vincenti F, Potter D, Stoney R, Duca R, Feduska N
Am J Surg. 1981 Jul;142(1):14-20. doi: 10.1016/s0002-9610(81)80004-9.
From analysis of results of more than 1,500 renal transplants has evolved a plan for donor selection and immunosuppressive management whereby patients with end-stage renal disease can obtain maximum graft and patient survival. With superior results in both patient and graft survival with living-related transplantation, this modality should be considered initially. Pretreatment with third party blood transfusions appears effective in all donor categories. Donor-specific blood transfusions have afforded 1-haplotype mixed lymphocyte culture-incompatible recipients enhanced opportunity for successful transplantation. Current results with living-related transplantation suggest realistic expectations of 1 and 2 year graft survival rates of greater than 90 percent. Curtailment of steroid therapy has resulted in improved patient survival at 1 and 2 years: 98 and 97 percent for recipients of living-related grafts, and 91 and 88 percent for recipients of cadaver grafts. These results, in combination with proper donor selection and appropriate recipient pretreatment with blood transfusions, have made renal transplantation a very effective therapeutic method in patients with end-stage renal disease.
通过对1500多例肾移植结果的分析，已形成了一种供体选择和免疫抑制管理方案，终末期肾病患者借此可获得最大的移植物存活和患者存活几率。由于亲属活体肾移植在患者和移植物存活方面效果更佳，应首先考虑这种移植方式。在所有供体类型中，术前输注第三方血液似乎都有效果。供体特异性输血使1个单倍型混合淋巴细胞培养不相容的受者有了更高的成功移植机会。目前亲属活体肾移植的结果表明，对1年和2年移植物存活率超过90%的预期是现实的。减少类固醇治疗已使患者1年和2年的存活率有所提高：亲属活体肾移植受者分别为98%和97%，尸体肾移植受者分别为91%和88%。这些结果，再加上合适的供体选择和对受者进行适当的输血预处理，使肾移植成为终末期肾病患者非常有效的治疗方法。
