肾移植1180例次生存分析

目的 总结我院２２年来临床肾移植的效果,分析探讨影响肾移植存活预后因素。方法 对我院１９７７年１０月至１９９９年６月间所作的１１８０例次（１０３９例患者）尸体肾移植的临床资料进行随访总结。并对可能影响移植肾存活的诸因素,如受者性别、受者年龄、移植次数、供者年龄、供受者性别配对、供受者血型配合、淋巴细胞毒交叉试验、冷缺血时间、延迟肾功能、肾功能正常时间、免疫者性别配对、供受者血型配合、淋巴细胞毒交叉

Survival analysis after kidney transplantation in 1,180 cadaveric graftings

OBJECTIVE: To analyze the outcome of twenty-two years of cadaveric kidney transplantation and the predict factors impacting on graft survival. METHODS: The data of 1,180 cadaveric kidney graftings in 1,039 patients between October of 1977 and June of 1999 were summarized by calculation of patient and graft survival rates using Kaplan-Meier product limit estimates. 13 factors that may influence on graft survival were analyzed by the log-rank and Cox model. RESULTS: The total of 1-, 5-, 10-, 15-, and 20-year patient survival rates were 93.02%, 80.25%, 67.86%, 65.34% and 65.34%, and the corresponding graft survival rates 88.6%, 68.3%, 43.8%, 43.8%, and 32.8%, respectively. Graft half-life was (13.98 +/- 0.96) years. The longest survivor was 22 years after cadaveric kidney transplantation. The quality of life after grafting in 835 alive patients was improved apparently; 95% of them had a normal graft function and 85% returned to work. The result of multivariable analysis using Cox model showed that 8 factors of patient's age, grafting time, pretransplant blood transfusion, cold ischemia time, delayed graft function, time of normal graft function, immunosuppressive regimen, and acute rejection were very important to affect the graft survival. CONCLUSION: Cadaveric kidney transplantation is a successful and effective method to rescue the patients with end-stage renal disease.