Öz
Amaç: Son dönem böbrek hastalığı (SDBH) morbidite ve mortalitesi yüksek bir durumdur. Böbrek nakli bu durumun hasta açısından en çok tercih edilen ve en çok fayda sağlayan tedavi yöntemidir. Yaş, transplantasyonun başarısını etkileyebilecek önemli bir faktördür. Bu çalışmada donör yaşının böbrek nakli sonuçları üzerindeki etkisini araştırdık.
Araçlar ve Yöntem: Bu çalışmaya canlı veya kadavradan böbrek nakli yapılmış 101 SDBH olan hasta retrospektif olarak incelendi. Vericilerin yaş, cinsiyet ve vücut kitle indeksi (VKİ) ve alıcıların yaş, cinsiyet, VKİ, hastanede yatış süreleri, tahmini glomerüler filtrasyon hızları (eGFR) ve serum kreatinin ölçümleri kaydedildi. Alıcı serum kreatinin seviyeleri, nakilden sonraki 18 aya kadar aralıklarla kaydedildi.
Bulgular: Donörler yaşlarına göre (<40 yaş (n:42), 40-50 yaş (n:25) ve >50 yaş (n:34)) olmak üzere 3 gruba ayrıldı. Vericinin cinsiyeti, VKİ, canlı/kadavra oranı ve alıcının cinsiyeti, yaşı ve VKİ açısından istatistiksel olarak anlamlı fark saptanmadı (p>0.05). Verici <40 yaş olan alıcıların hastanede kalış süreleri diğer yaş gruplarına göre istatistiksel olarak anlamlı derecede düşüktü ( p:0.001) 1. aydan 18. aya kadar donör yaşı arttıkça GFR'de istatistiksel olarak anlamlı azalma ve serum kreatinin değerinde artış gözlendi (p<0.05).
Sonuç: Donör yaşı, greft sağkalımı için önemli bir faktördür ve organ dağıtım prosedürlerinde göz önünde bulundurulmalıdır.
Anahtar Kelimeler
Kaynakça
- 1. Jeon HJ, Bae HJ, Ham YR, et al. Outcomes of end-stage renal disease patients on the waiting list for deceased donor kidney transplantation: A single-center study. Kidney Res Clin Pract. 2019;38(1):116-123.
- 2. Gander JC, Zhang X, Ross K, et al. Association Between Dialysis Facility Ownership and Access to Kidney Transplantation. JAMA. 2019;322(10):957-973.
- 3. Shahani MM, Iqbal T, Idrees MK. Impact of age and gender matching on long-term graft function and actual graft survival in live-related renal transplantation: Retrospective study from Sindh Institute of Urology and transplantation, Pakistan. Saudi J Kidney Dis Transpl. 2019;30(2):365-375.
- 4. Lin J, Zheng X, Xie ZL, et al. Factors potentially affecting the function of kidney grafts. Chin Med J (Engl). 2013;126(9):1738-1742.
- 5. Augliene R, Dalinkeviciene E, Kuzminskis V, et al. Factors influencing renal graft survival: 7-Year experience of a single center. Medicina (Kaunas). 2017; 53(4):224-232.
- 6. Sekito S, Nishikawa K, Masui S, et al. Effect of Donor Age on Graft Function and Pathologic Findings in Living Donor Transplantation. Transplant Proc. 2018;50(8):2431-2435.
- 7. Xin Z, Wu L, Zhou J, et al. Analysis of Factors Influencing Kidney Function of Recipients After Renal Transplantation in Southwestern China: A Retrospective Study. Front Med (Lausanne). 2020;7:519582.
- 8. Waiser J, Schreiber M, Budde K, et al. Age-matching in renal transplantation. Nephrol Dial Transplant. 2000;15(5):696-700.
- 9. Ali A, Asif N, Rais Z. Estimation of GFR by MDRD Formula and Its Correlation to Cockcroft-Gault Equation in Five Stages of Chronic Kidney Disease. Open J. Nephrol. 2013;3(1):4.
- 10. Cabrera J, Fernandez-Ruiz M, Trujillo H, et al. Kidney transplantation in the extremely elderly from extremely aged deceased donors: a kidney for each age. Nephrol Dial Transplant. 2020;35(4):687-696.
- 11. Jozwik A, Domagala P, Kieszek R, et al. Renal Transplantation Using Kidneys Procured From Elderly Donors Older Than 70 Years. Transplant Proc. 2016;48(5):1477-1481.
- 12. Ruggenenti P, Silvestre C, Boschiero L, et al. Long-term outcome of renal transplantation from octogenarian donors: A multicenter controlled study. Am J Transplant. 2017;17(12):3159-3171.
- 13. Foss A, Heldal K, Scott H, et al. Kidneys from deceased donors more than 75 years perform acceptably after transplantation. Transplantation. 2009;87(10): 1437-1441.
- 14. Filiopoulos V, Boletis JN. Renal transplantation with expanded criteria donors: Which is the optimal immunosuppression? World J Transplant. 2016;6(1): 103-114.
- 15. Lonning K, Midtvedt K, Leivestad T, et al. Are Octogenarians With End-Stage Renal Disease Candidates for Renal Transplantation? Transplantation. 2016; 100(12):2705-2709.
- 16. Fernandez-Lorente L, Riera L, Bestard O, et al. Long-term results of biopsy-guided selection and allocation of kidneys from older donors in older recipients. Am J Transplant. 2012;12(10):2781-2788.
- 17. Lim WH, Chang S, Chadban S, et al. Donor-recipient age matching improves years of graft function in deceased-donor kidney transplantation. Nephrol Dial Transplant. 2010;25(9):3082-3089.
Öz
Purpose: End-stage renal disease (ESRD) is a highly morbid and mortal condition. Renal transplantation is the most favorable and preferred solution of this disease. Age is an important factor that can effects the success of transplantation. In this study, we investigated the effect of donor age on the outcomes of kidney transplantation.
Materials and Methods: 101 ESRD patients who underwent live or cadaveric kidney transplantation were included and analyzed retrospectively in this study. We reviewed age, sex and body mass index (BMI) of the donors and age, sex, BMI, length of stay, estimated glomerular filtration rate (eGFR) and serum creatinine measurements of the recipients were recorded. Recipient serum creatinine levels were determined at intervals up to 18 months after transplantation.
Results: Donors were divided into 3 groups according to age (<40 years (n:42), 40-50 years (n:25) and >50 years (n:34). There was no statistically significant difference between the groups in terms of donor's gender, BMI, living/cadaveric ratio, and recipient's gender, age, and BMI (p>0.05). Length of hospital stay of recipients whose donor <40 years old were statistically significantly lower compared to other age groups (p:0.001). From the 1st month to the 18th month, a statistically significant decrease in GFR and an increase in serum creatinine were observed as the donor age increased (p<0.05).
Conclusion: Donor age is an important factor for the graft survival and for the allocation procedures it should be kept in mind.
Anahtar Kelimeler
Kaynakça
- 1. Jeon HJ, Bae HJ, Ham YR, et al. Outcomes of end-stage renal disease patients on the waiting list for deceased donor kidney transplantation: A single-center study. Kidney Res Clin Pract. 2019;38(1):116-123.
- 2. Gander JC, Zhang X, Ross K, et al. Association Between Dialysis Facility Ownership and Access to Kidney Transplantation. JAMA. 2019;322(10):957-973.
- 3. Shahani MM, Iqbal T, Idrees MK. Impact of age and gender matching on long-term graft function and actual graft survival in live-related renal transplantation: Retrospective study from Sindh Institute of Urology and transplantation, Pakistan. Saudi J Kidney Dis Transpl. 2019;30(2):365-375.
- 4. Lin J, Zheng X, Xie ZL, et al. Factors potentially affecting the function of kidney grafts. Chin Med J (Engl). 2013;126(9):1738-1742.
- 5. Augliene R, Dalinkeviciene E, Kuzminskis V, et al. Factors influencing renal graft survival: 7-Year experience of a single center. Medicina (Kaunas). 2017; 53(4):224-232.
- 6. Sekito S, Nishikawa K, Masui S, et al. Effect of Donor Age on Graft Function and Pathologic Findings in Living Donor Transplantation. Transplant Proc. 2018;50(8):2431-2435.
- 7. Xin Z, Wu L, Zhou J, et al. Analysis of Factors Influencing Kidney Function of Recipients After Renal Transplantation in Southwestern China: A Retrospective Study. Front Med (Lausanne). 2020;7:519582.
- 8. Waiser J, Schreiber M, Budde K, et al. Age-matching in renal transplantation. Nephrol Dial Transplant. 2000;15(5):696-700.
- 9. Ali A, Asif N, Rais Z. Estimation of GFR by MDRD Formula and Its Correlation to Cockcroft-Gault Equation in Five Stages of Chronic Kidney Disease. Open J. Nephrol. 2013;3(1):4.
- 10. Cabrera J, Fernandez-Ruiz M, Trujillo H, et al. Kidney transplantation in the extremely elderly from extremely aged deceased donors: a kidney for each age. Nephrol Dial Transplant. 2020;35(4):687-696.
- 11. Jozwik A, Domagala P, Kieszek R, et al. Renal Transplantation Using Kidneys Procured From Elderly Donors Older Than 70 Years. Transplant Proc. 2016;48(5):1477-1481.
- 12. Ruggenenti P, Silvestre C, Boschiero L, et al. Long-term outcome of renal transplantation from octogenarian donors: A multicenter controlled study. Am J Transplant. 2017;17(12):3159-3171.
- 13. Foss A, Heldal K, Scott H, et al. Kidneys from deceased donors more than 75 years perform acceptably after transplantation. Transplantation. 2009;87(10): 1437-1441.
- 14. Filiopoulos V, Boletis JN. Renal transplantation with expanded criteria donors: Which is the optimal immunosuppression? World J Transplant. 2016;6(1): 103-114.
- 15. Lonning K, Midtvedt K, Leivestad T, et al. Are Octogenarians With End-Stage Renal Disease Candidates for Renal Transplantation? Transplantation. 2016; 100(12):2705-2709.
- 16. Fernandez-Lorente L, Riera L, Bestard O, et al. Long-term results of biopsy-guided selection and allocation of kidneys from older donors in older recipients. Am J Transplant. 2012;12(10):2781-2788.
- 17. Lim WH, Chang S, Chadban S, et al. Donor-recipient age matching improves years of graft function in deceased-donor kidney transplantation. Nephrol Dial Transplant. 2010;25(9):3082-3089.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri, Klinik Tıp Bilimleri (Diğer) |
| Bölüm | Bilimsel Araştırma Makaleleri |
| Yazarlar | |
| Erken Görünüm Tarihi | 5 Temmuz 2023 |
| Yayımlanma Tarihi | 7 Ağustos 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 7 Sayı: 2 |
Kaynak Göster
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