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目的:比较国人活体肾移植与尸体肾移植的疗效并分析相关因素。方法:对同期154例活体肾移植受体(活体供肾组)和包括DCD供体在内的262例尸体肾移植受体(尸体供肾组)随访12~58个月,分析比较两组患者移植肾并发症、肾功能和人肾累积存活率情况。结果:活体供肾组和尸体供肾组分别发生急性排斥反应(AR)18例(11.7%)和59例(22.5%)(P=0.006),移植物功能延迟恢复(DGF)6例(3.9%)和28例(10.7%)(P=0.015)。两组在7天、1、3、6、12、36个月六个随访点的Ccr和Scr结果显示,早期活体供肾组移植肾功能恢复稍快,但在术后12和36个月时,两组Ccr和Scr的差异并无统计学意义。活体供肾组和尸体供肾组在整个随访期内的人肾累积存活率差异也无统计学意义,1年时人累积存活率分别为96.5%和97.9%(P=0.414),移植物累积存活率为96.2%和97.4%(P=0.726);3年时人累积存活率分别为96.2%和95.8%(P=0.846),移植物累积存活率为93.7%和92.8%(P=0.875)。结论:两种供肾方式受体1年和3年人肾累积存活率相似。活体肾移植受体AR、DGF等并发症发生率较低,早期肾功能恢复稍快,但1年及3年时肾功能与尸体肾移植相似,随访期内活体供肾组受体最佳肾功能出现在术后3年时,而尸体供肾组出现在术后3个月时。
Objective: To compare the efficacy of living donor kidney transplantation and cadaver kidney transplantation in China and to analyze the related factors. Methods: A total of 154 live donor kidney transplant recipients (living donor group) and 262 cadaveric renal transplant recipients (cadaver donor group) were enrolled in this study. The patients were followed up for 12 to 58 months. Transplanted kidney complications, renal function and cumulative survival rate of human kidney. Results: There were 18 cases (11.7%) and 59 cases (22.5%) of acute rejection (AR) and 6 cases (3.9%) of delayed graft function (DGF) %) And 28 cases (10.7%) (P = 0.015). The results of Ccr and Scr in six follow-up sites at 7 days, 1, 3, 6, 12, and 36 months showed that the renal function of the early living donor kidney group recovered slightly, but at 12 and 36 months There was no significant difference between the two groups in Ccr and Scr. There was also no significant difference in cumulative survival rate of human kidney between the donor-donor group and the donor-donor group over the follow-up period. The cumulative survival rates at one year were 96.5% and 97.9%, respectively (P = 0.414) The survival rates were 96.2% and 97.4% (P = 0.726). The cumulative survival rates were 96.2% and 95.8% at 3 years (P = 0.846), and the cumulative survival rates were 93.7% and 92.8% . CONCLUSION: The cumulative survival rates of human kidney for one year and three years of the two donor receptors are similar. The incidence of complications such as AR, DGF and other complications of living kidney transplant recipients was lower, and the recovery of early renal function was slightly faster. However, at 1 year and 3 years, renal function was similar to that of cadaveric kidney transplantation. During follow-up, Function appeared in 3 years after surgery, while the body donor kidney group appeared at 3 months after surgery.