Gofrit O, Eid A, Friedlander M, Rubinger D, Brautbar C, Shiloni E, Reissman P, Rivkind A, Durst A, Berlatzki Y
Dept. of General and Transplantation Surgery, Hadassah-University Hospital, Jerusalem.
Harefuah. 1995 Feb 15;128(4):201-4, 264.
Kidney transplantation is the best treatment for selected end-stage renal patients. The shortage of cadaveric organs for transplantation has led to the development of a protocol for kidney transplantation from living, related donors. In the past 20 years, 58 living, related kidney transplantations were done in our department. Mean patient age was 30 +/- 10 (SD) years and mean donor age was 36 +/- 10. There were 34 transplantations between brothers or sisters, 15 from parent to child, 4 between cousins, 4 between spouses and 1 from son to father. Mean follow-up time was 4 years. 1 and 5 years after transplantation, patient survival rates were 85% and 80%, respectively, graft survival rates were 85% and 75%. The introduction of cyclosporin-A as an immunosuppressive agent in 1985 led to improvement in graft survival rates: from 77% and 51% after 1 and 5 years, respectively, to 88% and 84%. No correlation between HLA match or patient's age and graft survival rates was found. We conclude that living, related donor transplantation is effective for suitable cases of end-stage renal disease. It should be recommended to patients who have a healthy, interested family member.
肾移植是部分终末期肾病患者的最佳治疗方法。尸体供肾短缺促使了亲属活体肾移植方案的发展。在过去20年里，我科共进行了58例亲属活体肾移植。患者平均年龄为30±10（标准差）岁，供者平均年龄为36±10岁。其中，兄弟姐妹间移植34例，父母向子女移植15例，表亲间移植4例，配偶间移植4例，儿子向父亲移植1例。平均随访时间为4年。移植后1年和5年时，患者生存率分别为85%和80%，移植肾生存率分别为85%和75%。1985年引入环孢素A作为免疫抑制剂后，移植肾生存率有所提高：从1年和5年后分别为77%和51%提高到88%和84%。未发现HLA配型或患者年龄与移植肾生存率之间存在相关性。我们得出结论，亲属活体供肾移植对合适的终末期肾病病例有效。对于有健康且愿意捐献的家庭成员的患者，应推荐该治疗方法。
