nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2005-9-3-67-69nefr-683Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИ. КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯORIGINAL ARTICLES. CLINICAL INVESTIGATIONSТРАНСПЛАНТАЦИЯ ПОЧКИ ОТ ЖИВЫХ ДОНОРОВ В ВОЗРАСТЕ СТАРШЕ 60 ЛЕТ И ЕЁ ОТДАЛЕННЫЕ РЕЗУЛЬТАТЫLIVING KIDNEY TRANSPLANTATION FROM DONORS OVER SIXTY AND ITS RESULTS IN THE LATE FOLLOW-UPРайниенеТ.RainieneT.

Центр лабораторной диагностики

ТрофименкоИ. И.TrofimenkoI. I.

Перевод с английского

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Kлиники Сантарискиу, госпиталь Вильнюсского университетаLithuania200510032005936769Copyright © Райниене Т., Трофименко И.И., 20052005Райниене Т., Трофименко И.И.Rainiene T., Trofimenko I.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/683

ЦЕЛЬ ИССЛЕДОВАНИЯ – оценить отдаленные исходы трансплантации почек (потеря трансплантата и его функции) от пожилых людей (60 лет и старше) по сравнению с контрольной группой доноров моложе 60 лет. ПАЦИЕНТЫ И МЕТОДЫ. Проанализированы результаты 154 трансплантаций почек от живых родственных и не родственных (супруги) доноров, произведенных между 1992 годом и маем 2002 года. Все пациенты были разделены на две группы в зависимости от возраста доноров: первая (n=44) – средний возраст доноров 66,4±4,9 (60–78) лет и вторая (контрольная; n=110) – средний возраст доноров 47,9±7,9 (22–59) лет. Поддерживающая иммуносупрессия состояла из циклоспорина, азатиоприна или микофенолат мофетила и преднизолона. Функцию трансплантата оценивали по уровню креатинина сыворотки крови. Для сравнения различий между группами был использован χ2 тест. РЕЗУЛЬТАТЫ. Трансплантаты от пожилых доноров составили 28,6%. Средний возраст реципиентов (36,6±9,4 vs 30,2±11,4), доля повторных трансплантаций (4,5% vs 6,4%), совместимость по HLAсистеме (3,59 vs 3.1), число сенсибилизированных (PRA≥50%) пациентов (6,8% vs 3,6%) было сходным в обеих группах. Длительно наблюдались 37 больных из первой группы и 96 из второй. В течение первого года не было обнаружено значимых отличий в состоянии пациентов и частоте гибели трансплантатов. Доля реципиентов с хорошей и удовлетворительной функцией трансплантата в первой группе была достоверно ниже, чем во второй: 81,1% vs 93,8% (χ2=4,8604 p<0,05) через год, 73,0% vs 89,6% (χ2 =5,5124, p<0,02) через 3 года и 50,0% vs 93,2% (χ2 =15,3014, p<0,001) через 5 лет соответственно. ЗАКЛЮЧЕНИЕ. Риск развития хронического отторжения трансплантированной почки при длительном наблюдении не зависит от возраста доноров. Хорошее и удовлетворительное состояние функции трансплантата при пересадке почки от пожилых людей наблюдается реже чем при трансплантации от более молодых живых доноров.

THE AIM of the investigation was to assess longterm outcomes (loss of transplant and its function) of transplantation of the kidneys from elderly (≥ 60 years) donors and compare them to a control group of donors <60 years. PATIENTS AND METHODS. Results of 154 renal transplantations from living related and nonrelated (spouses) donors performed between 1992 and May 2002 were analyzed. All patients were divided into two groups according to the donors’ age: group 1 (n=44) mean age of donor 66.4±4.9 (6078) years and group 2 (control group, n=110) mean age of donors 47.9±7.9 (2259) years. The maintenance immunosuppression consisted of cyclosporine, azathioprine or mofetil mycophenolate and prednisolone. The graft function was evaluated by serum creatinine concentration levels. The χ 2  test was used to compare differences between the groups. RESULTS. Transplants from elderly donors made up 28.6% of all living donor transplants. Mean age of the recipients (36.6±9.4 vs 30.2±11.4), percentage of retransplanted patients (4.5% vs 6.4%), HLA match (3.59 vs 3.1), number of sensitizated (PRA ≥ 50%) patients (6.8% vs 3.6%) were similar in both groups. In group 1 37 patients and 96 patients from group 2 were followed up for a year after transplantation. No statistically significant differences in the patients’ state and graft loss were found during the first year. The percentage of recipients with excellent and good graft function in group 1 was statistically significantly lower than in group 2: 81.1% vs 93.8% (χ2 =4.8604 p<0.05) in a year, 73.0% vs 89.6% (χ2 =5.5124 , p< 0.02) in 3 years and 50.0% vs 93.2% (χ2 = 15.3014, p<0.001) in 5 years respectively. CONCLUSION. The risk of chronic rejection of the transplanted kidney is independent of the donor’s age. Excellent and good state of the graft from elderly donors was observed more rarely than of the graft from younger donors.

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The authors declare that there are no conflicts of interest present.