CAJ | 학술논문

目的分析老年活体供肾移植术后供者的安全性及受者的移植效果.方法回顾性分析251例亲属活体供肾移植的临床资料.根据供者年龄,将251例活体供肾移植分为老年供肾组(≥55岁)和中青年供肾组(<55岁),对手术前后两组供、受者的血清肌酐(Cr)、肾小球滤过率(GFR)、内生肌酐清除率(Ccr)、并发症、平均住院时间以及受者的人/肾存活率、急性排斥反应发生率进行比较和分析.结果老年供肾组和中青年供肾组供者手术前后血Cr水平的差异无统计学意义(P>0.05),而Ccr的差异有统计学意义(P<0.05).老年供肾组与中青年供肾组供者比较,术前总GFR、留存肾GFR及术后10 d留存肾GFR比较,差异均无统计学意义(P>0.05);老年供肾组供者术后10 d与术前的留存肾GFR比较,差异无统计学意义(P>0.05);中青年供肾组供者术后10 d的留存肾GFR较术前明显上升,差异有统计学意义(P<0.05).老年供肾组与中青年供肾组受者比较,手术前后各相应时间点的血Cr水平差异无统计学意义(P>0.05).老年供肾组和中青年供肾组供者平均住院时间分别为(16.67±7.78)d和(16.11±5.89)d(P>0.05),受者平均住院时间分别为(29.61±24.28)d和(28.76±19.27)d(P>0.05).两组受者6个月内急性排斥反应发生率分别为6.50%和5.75%(P>0.05).老年供肾组受者术后死亡1例,中青年供肾组死亡3例,并有1例因急性排斥反应切除移植肾.结论老年活体供肾移植术前应对供者进行严格的选择,在进行全面系统评估的前提下,可以保证供者术后的安全以及受者的移植效果.
목적 분석노년활체공신이식술후공자적안전성급수자적이식효과.방법 회고성분석251례친속활체공신이식적림상자료.근거공자년령,장251례활체공신이식분위노년공신조(≥55세)화중청년공신조(<55세),대수술전후량조공、수자적혈청기항(Cr)、신소구려과솔(GFR)、내생기항청제솔(Ccr)、병발증、평균주원시간이급수자적인/신존활솔、급성배척반응발생솔진행비교화분석.결과 노년공신조화중청년공신조공자수술전후혈Cr수평적차이무통계학의의(P>0.05),이Ccr적차이유통계학의의(P<0.05).노년공신조여중청년공신조공자비교,술전총GFR、류존신GFR급술후10 d류존신GFR비교,차이균무통계학의의(P>0.05);노년공신조공자술후10 d여술전적류존신GFR비교,차이무통계학의의(P>0.05);중청년공신조공자술후10 d적류존신GFR교술전명현상승,차이유통계학의의(P<0.05).노년공신조여중청년공신조수자비교,수술전후각상응시간점적혈Cr수평차이무통계학의의(P>0.05).노년공신조화중청년공신조공자평균주원시간분별위(16.67±7.78)d화(16.11±5.89)d(P>0.05),수자평균주원시간분별위(29.61±24.28)d화(28.76±19.27)d(P>0.05).량조수자6개월내급성배척반응발생솔분별위6.50%화5.75%(P>0.05).노년공신조수자술후사망1례,중청년공신조사망3례,병유1례인급성배척반응절제이식신.결론 노년활체공신이식술전응대공자진행엄격적선택,재진행전면계통평고적전제하,가이보증공자술후적안전이급수자적이식효과.
Objective To investigate the safety for donors and the effectiveness for recipients of living-related donor (LRD) kidney transplantation from elder donors. Methods 251 cases of LRD kidney transplantation were reviewed. According to the age of LRDs, the patients were divided into 2 groups:≥55 years group (group A) and <55 years (group B). The parameters studied included serum creatinine (Cr), glomerular filtration rate (GFR), creatinine clearance (Ccr), perioperative complications, average hospital stay, and acute rejection rate of LRDs and recipients were compared. Results (1)There was no significant difference in serum Cr between groups A and B at different time points (P>0.05). (2)There was no significant difference in Ccr between two groups pre-donation (P = 0.45). But at the 10th day after the donor nephrectomy, Ccr level in group A was significant lower than in group B (P<0.01). (3)Total GFR pre-donation, remaining renal GFR, and remaining renal GFR on the day 10 after donation had no significant difference in both groups A and B (P>0.05). Remaining renal GFR on the day 10 before and after donation had no significant difference in group A (P>0.05), but on the day 10 after donation that was significantly increased in group B as compared with that pre-donation (P<0.01). (4) The serum Cr of recipients at different time points after transplantation had no significant difference between two groups (P>0.05). (5) The mean hospital stay after donation of LRDs and recipients had no significant difference between two groups. (6) The incidence of recipients" acute rejection was 6.50 % (5/77) in group A, and 5.75%(10/174) in group B within 6 months after operation (P = 0.95). Conclusion Transplantations performed from the elderly donors will yield similar results from younger donors if the eider donors are evaluated or assessed as the standards.