大于50岁亲属活体供肾移植效果分析

目的探讨50岁亲属活体供肾移植的移植效果。方法 1993年4月～2007年12月施行亲属活体供肾移植107例,按照供者年龄分为两组,其中50岁为研究组,45例,≤50岁为对照组,62例。随访时间12～180个月,平均49个月。比较两组受者术后肾功能恢复情况、并发症及近、远期移植肾功能、人/肾存活率等。结果移植手术均获成功。两组受者在年龄、术前透析时间、配型、肾缺血时间、抗排斥方案应用等方面比较显示均衡性良好,术后1周、1月、1年、3年Scr水平及1、3、5、8年人/肾存活率组间比较差异均无统计学意义(P0.05)。结论供者年龄50岁亲属活体供肾移植效果,满意年龄非亲属活体供肾绝对禁忌症。

The clinical analysis of living related renal transplantation with donors over 50-year-old

Objective] The aim of this study was to investigate whether utilization of kidneys from living related elderly（older than 50 years）donors is safe for recipients in the long term.Methods] one hundred and seven cases of living related donor kidney transplantation were performed in our center from April 1994 to December 2007.According to the donors＇ age,the recipients were divided in 2 groups：50 years group and ≤50 years group.Mean follow up was 49 months（12～180months）.Clinical data including recipients＇ postoperative recovery of renal function,complications and the near and long-term graft function,recipient /kidney survival were analyzed and compared.Results] The operations were all very successful.The comparisons of recipients＇ age,duration on dialysis,HLA matches,cold/warm ischemia time,immunosuppression show a good balance between two groups.The mean recipients＇ serum creatinines at 1 week,1 month,1 year and 3 years were 106.00±8.68 umol/L,88.62±10.81 umol/L,110.96±9.78 umol/L,148.40±52.44 umol/L in study group,which were higher than 103.89±9.29 umol/L,85.65±7.42 umol/L,108.15±9.40 umol/L,140.66±34.21 umol/L in control group respectively.but the differences were not significant（P0.05）.One-,3-,5-and 8-year recipient/graft survival were 100%/97.8%,96.7%/86.7,88.9%/77.8%,80%/60% in study group,and they were 100%/98.4%,97.4%/92.3%,90.5%/80.9%,85.7%/71.4% in control group respectively.There were no significant differences either（P0.05）.Conclusions] The long-term follow up shows that transplantations performed from the elderly donors yielded similar results to those of conventional donors,which may encourage us to be more flexible about donor selection.