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原发性疾病对尸体供肾移植受者的长期影响。

The long-term effect of primary disease on cadaver-donor renal transplant recipients.

作者信息

Hirata M, Terasaki P I

出版信息

Clin Transpl. 1993:485-98.

PMID:7918183
Abstract
  1. Graft survival was similar at one year for the various diseases, but at 3 years, a 16% divergence was noted among diseases. IGAN patients had the highest graft survival rate. 2. Graft survival rates of IGAN, ALP, and PC in Black and White patients were similar, but in all other diseases, a high loss rate was seen after one year among Black patients. 3. Patient survival was almost identical for the various diseases among Whites and Blacks. 4. SLE patients with DR2 or DR3 had higher graft survival rates than SLE patients without these groups (p < 0.05 in Whites). 5. IDDM patients with DR3 or DR4 had higher graft survival rates than IDDM patients without these groups (p < 0.05 in Whites, p = ns in Blacks). 6. Nephrosclerosis patients with DR2 or DR4 had higher graft survival rates than those who did not (p = ns in Whites, p < 0.05 in Blacks). 7. CGN patients with DR1 had higher graft survival rates than CGN patients without DR1 (p < 0.00005 in Whites). 8. IDDM patients with SPK transplants had higher graft survival rates than IDDM patients grafted with a KAT (p < 0.000001). In recent years, almost 30% of IDDM patients had SPK transplants. 9. Patients with SPK grafts compared to KAT were younger, White, were more often DR3/4, and worked full-time. 10. The SPK effect was seen only at the excellent centers. At all other centers, SPK and KAT patients had the same graft survival rates.
摘要
  1. 不同疾病的移植物1年存活率相似,但3年时,疾病间出现了16%的差异。IgA肾病患者的移植物存活率最高。2. IgA肾病、淀粉样变性和多囊肾病患者在黑人和白人中的移植物存活率相似,但在所有其他疾病中,黑人患者1年后的失功率较高。3. 白人和黑人中,不同疾病患者的生存率几乎相同。4. 携带DR2或DR3的系统性红斑狼疮患者的移植物存活率高于未携带这些基因的系统性红斑狼疮患者(白人中p<0.05)。5. 携带DR3或DR4的胰岛素依赖型糖尿病患者的移植物存活率高于未携带这些基因的患者(白人中p<0.05,黑人中p=无统计学意义)。6. 携带DR2或DR4的肾硬化患者的移植物存活率高于未携带的患者(白人中p=无统计学意义,黑人中p<0.05)。7. 携带DR1的慢性肾小球肾炎患者的移植物存活率高于未携带DR1的患者(白人中p<0.00005)。8. 接受胰肾联合移植的胰岛素依赖型糖尿病患者的移植物存活率高于接受肾移植的患者(p<0.000001)。近年来,近30%的胰岛素依赖型糖尿病患者接受了胰肾联合移植。9. 与接受肾移植的患者相比,接受胰肾联合移植的患者更年轻、为白人、更常携带DR3/4且为全职工作。10. 胰肾联合移植的效果仅在优秀中心可见。在所有其他中心,接受胰肾联合移植和肾移植的患者移植物存活率相同。

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