Tesi R J, Elkhammas E A, Davies E A, Henry M L, Ferguson R M
Ohio State University, Department of Surgery, Columbus.
Lancet. 1994 Feb 19;343(8895):461-4. doi: 10.1016/s0140-6736(94)92698-0.
Renal transplantation in people 60 years old or more is controversial due to the morbidity associated with immunosuppression and the scarcity of renal allografts. We have reviewed the outcome of 1222 consecutive renal transplants done at a single institution with a uniform immunosuppressive protocol over 10 years. 5-year graft survival was the same in the under sixties as in the sixties and over. Patient survival was worse in the older group (p = 0.0001), but there were significantly fewer immunological graft losses: 11% vs 31% (p = 0.0009; relative risk [RR] = 0.36 [95% confidence interval 0.19-0.66]). A majority of the deaths in both groups were secondary to cardiovascular disease, not due to complications of immunosuppression. We conclude that renal transplantation in people 60 and over has results equivalent to a younger population. Age 60 and over should not be a major factor in considering if a patient is eligible for renal transplantation.
由于免疫抑制相关的发病率以及肾移植供体的稀缺，60岁及以上人群的肾移植存在争议。我们回顾了在一家机构采用统一免疫抑制方案连续进行的1222例肾移植在10年期间的结果。60岁以下患者和60岁及以上患者的5年移植物存活率相同。老年组的患者存活率较差（p = 0.0001），但免疫性移植物丢失明显较少：分别为11%和31%（p = 0.0009；相对风险[RR] = 0.36 [95%置信区间0.19 - 0.66]）。两组中的大多数死亡均继发于心血管疾病，而非免疫抑制并发症。我们得出结论，60岁及以上人群的肾移植结果与年轻人群相当。60岁及以上不应成为考虑患者是否适合肾移植的主要因素。
