UNASSIGNED: Transplant outcomes (survival and estimated renal function) were assessed after live and deceased donor transplantation from the US national database. Outcomes were stratified by age (donor and recipient) and donor type.
UNASSIGNED: Aggregate recipient outcomes were better transplanting living vs deceased donated kidneys. However, when stratified by the one-year renal function (within KDIGO CKD stage stratifications), surviving recipients had clinically similar dialysis-freedom, irrespective of donor type or age. The major outcome differences for recipients of age-stratified live and deceased kidneys was 1) the increasing frequency of one-year graft failures and 2) the increasing likelihood of severely limited renal function (CKD 4/5) with advancing donor age. Over 30% of recipients of deceased kidneys >65 years had either one-year graft failure or severely limited renal function contrasted to less than 15% of recipients of live kidneys aged >65 years.
UNASSIGNED: Evolving techniques to reduce adverse events after urgent vs elective procedures, plus improved transplant outcome predictability with increased-age deceased donor kidneys using advanced predictive analytics (using age-stratified live kidney transplantation outcomes as a relevant reference point) should facilitate similar kidney transplant outcomes, irrespective of donor type.
■移植结果(存活率和估计的肾功能)在来自美国国家数据库的活体和死亡供体移植后进行评估。结果按年龄(供体和受体)和供体类型分层。
■总的受者结果是更好的活体移植与死者捐赠的肾脏。然而,当按一年肾功能分层时(在KDIGOCKD阶段分层内),幸存的受者具有临床上相似的透析自由度,无论供体类型或年龄。年龄分层的活体和死亡肾脏的受体的主要结果差异是:1)一年移植失败的频率增加;2)随着供体年龄的增长,严重受限的肾功能(CKD4/5)的可能性增加。超过30%的>65岁的死亡肾脏的接受者患有一年的移植物衰竭或肾功能严重受限,相比之下,年龄>65岁的活肾脏的接受者不到15%。
■改进技术以减少紧急和选择性手术后的不良事件,再加上使用先进的预测分析(使用年龄分层的活体肾移植结果作为相关参考点)对年龄增加的死亡供体肾脏的移植结果可预测性的改善,应该有助于类似的肾移植结果,无论供体类型。