首页> 外文期刊>Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association - European Renal Association >Long-term survival benefit from dual kidney transplantation using kidneys from donors with very extended criteria-a French cohort between 2002 and 2014
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Long-term survival benefit from dual kidney transplantation using kidneys from donors with very extended criteria-a French cohort between 2002 and 2014

机译:2002 年至 2014 年间法国队列研究的双肾移植使用具有非常扩展标准的供体肾脏进行双肾移植的长期生存获益

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Background This national multicentre retrospective cohort study aimed to assess the long-term outcomes of dual kidney transplantation (DKT) and compare them with those obtained from single kidney transplantation (SKT). Methods Our first analysis concerned all first transplants performed between May 2002 and December 2014, from marginal donors, defined as brain death donors older than 65 years, with an estimated glomerular filtration rate (eGFR) lower than 90 mL/min/1.73 m(2). The second analysis was restricted to transplants adequately allocated according to the French DKT program based on donor eGFR: DKT for eGFR between 30 and 60, SKT for eGFR between 60 and 90 mL/min/1.73 m(2). Recipients younger than 65 years or with a panel-reactive antibody percentage >= 25 were excluded. Results The first analysis included 461 DKT and 1131 SKT. DKT donors were significantly older (77.6 versus 74 years), had a more frequent history of hypertension and a lower eGFR (55.1 versus 63.6 mL/min/1.73 m(2)). While primary nonfunction and delayed graft function did not differ between SKT and DKT, 1-year eGFR was lower in SKT recipients (39 versus 49 mL/min/1.73 m(2), P < 0.001). Graft survival was significantly better in DKT, even after adjustment for recipient and donor risk factors. Nevertheless, patient survival did not differ between these groups. The second analysis included 293 DKT and 687 SKT adequately allocated with donor eGFR and displayed similar results but with a smaller benefit in terms of graft survival. Conclusions In a context of organ shortage, DKT is a good option for optimizing the use of kidneys from very expanded criteria donors.
机译:背景 这项全国性多中心回顾性队列研究旨在评估双肾移植 (DKT) 的长期结果,并将其与单肾移植 (SKT) 获得的结果进行比较。方法 我们的第一次分析涉及 2002 年 5 月至 2014 年 12 月期间进行的所有首次移植,这些移植来自边缘供体,定义为 65 岁以上的脑死亡供体,估计肾小球滤过率 (eGFR) 低于 90 mL/min/1.73 m(2)。第二项分析仅限于根据法国 DKT 计划基于供体 eGFR 充分分配的移植:eGFR 的 DKT 在 30 至 60 之间,eGFR 的 SKT 在 60 至 90 mL/min/1.73 m(2) 之间。年龄小于 65 岁或面板反应性抗体百分比 >= 25% 的接受者被排除在外。结果 第一次分析包括461 DKT和1131 SKT。DKT供体年龄显著较大(77.6岁 vs 74岁),高血压病史更频繁,eGFR更低(55.1 vs 63.6mL/min/1.73m(2))。虽然原发性无功能和延迟移植功能在SKT和DKT之间没有差异,但SKT受者的1年eGFR较低(39 vs 49 mL/min/1.73 m(2),P < 0.001)。DKT的移植物存活率明显更好,即使在调整受体和供体风险因素后也是如此。然而,这些组之间的患者生存率没有差异。第二项分析包括 293 DKT 和 687 SKT 与供体 eGFR 充分分配,并显示出相似的结果,但在移植物存活率方面获益较小。结论 在器官短缺的情况下,DKT是优化使用来自非常广泛的标准供体的肾脏的良好选择。

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