摘要
目的 总结我院 2 2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 (10 39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、免疫抑制药物治疗、移植前输血以及急性排斥反应等 13个因素 35个水平 ,进行log rank单因素分析和COX模型多因素回归分析。 结果 总的 1、5、10、15、2 0年人存活率分别为 93 0 2 %、80 2 5 %、6 7 86 %、6 5 34 %和 6 5 34 % ;肾存活率分别为 88 6 3%、6 8 33%、43 77%、43 77%和 32 83%。总的移植肾半生存期为 (13 98± 0 96 )年。术后至今最长带功能肾存活者为 2 2年 ,90 5 %的患者移植肾功能保持正常 ,85 9%的患者已恢复全天工作。单因素与多因素分析结果表明 :冷缺血时间 ,延迟肾功能、肾功能正常时间、免疫抑制药物治疗、移植前输血以及急性排斥反应等 6个因素可对移植肾的存活率发生重要或非常重要的影响。 结论 尸体肾移植是救治晚期肾功能衰竭患者的成功有效方法。
Objective[WT5”BZ] To analyze the outcome of twenty two years of cadaveric kidney transplantation and the predict factors impacting on graft survival. [WT5”HZ]Methods[WT5”BZ] 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. [WT5”HZ]Results[WT5”BZ] 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 affact the graft survival. [WT5”HZ]Conclusion[WT5”BZ] Cadaveric kidney transplantation is a successful and effective method to rescue the patients with end stage renal disease. [WT5”HZ]
出处
《中华外科杂志》
CAS
CSCD
北大核心
2000年第8期578-581,共4页
Chinese Journal of Surgery
关键词
肾移植
存活率
预后因素
生存率
Kidney transplantation
Survival
Predict factors
