Long-term Kidney Transplant Survival Across the Globe.

IF 5.3 2区医学 Q1 IMMUNOLOGY Transplantation Pub Date : 2024-09-01 Epub Date: 2024-03-19 DOI:10.1097/TP.0000000000004977

Sundaram Hariharan, Natasha Rogers, Maarten Naesens, J Medina Pestana, Gustavo F Ferreira, Lucio R Requião-Moura, Renato D Foresto, S Joseph Kim, Katrina Sullivan, Ilkka Helanterä, Valentin Goutaudier, Alexandre Loupy, Vivek B Kute, Massimo Cardillo, Kazunari Tanabe, Anders Åsberg, Trond Jensen, Beatriz Mahillo, Jong Cheol Jeong, Vathsala Anantharaman, Chris Callaghan, Rommel Ravanan, Derek Manas, Ajay K Israni, Rajil B Mehta

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Abstract

Background: The outcomes after kidney transplantation (KT), including access, wait time, and other issues around the globe, have been studied. However, issues do vary from one country to another.

Methods: We obtained data from several countries from North America, South America, Europe, Asia, and Australia, including the number of patients awaiting KT from 2015, transplant rate per million population (pmp), proportion of living donor and deceased donor (LD/DD) KT, and posttransplant survival. We also sought opinions on key difficulties faced by each of these countries with respect to KT and long-term survival.

Results: Variation in access to KT across the globe was noted. Countries with the highest rates of KT pmp included the United States (79%) and Spain (71%). A higher proportion of LD transplants was noted in Japan (93%), India (85%), Singapore (63%), and South Korea (63%). A higher proportion of DD KTs was noted in Spain (90%), Brazil (90%), France (85%), Italy (85%), Finland (85%), Australia-New Zealand (80%), and the United States (77%). The 5-y graft survival for LD was highest in South Korea (95%), Singapore (94%), Italy (93%), Finland (93%), and Japan (93%), whereas for DD, it was South Korea (93%), Italy (88%), Japan (86%), and Singapore (86%). The common issues surrounding KTs are access and a limited number of LDs and DDs. Key issues identified for long-term survival were increasing age of donors and recipients, higher recipient comorbidity, and posttransplant events, such as alloimmune injury to the kidney, infection, cancer, and suboptimal adherence to therapy.

Conclusions: A unified approach is necessary to improve issues surrounding KT as the demand continues to increase.

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全球肾移植的长期存活率。

背景：已经对全球肾移植（KT）后的结果，包括获取途径、等待时间和其他问题进行了研究。然而，不同国家的问题确实各不相同：我们从北美、南美、欧洲、亚洲和澳大利亚的多个国家获取了数据，包括 2015 年以来等待肾移植的患者人数、每百万人口的移植率（pmp）、活体和死亡供体（LD/DD）肾移植的比例以及移植后存活率。我们还就这些国家在KT和长期存活率方面面临的主要困难征求了意见：结果：我们注意到全球各地在获得 KT 方面存在差异。KT pmp 率最高的国家包括美国（79%）和西班牙（71%）。日本（93%）、印度（85%）、新加坡（63%）和韩国（63%）的低密度移植比例较高。西班牙（90%）、巴西（90%）、法国（85%）、意大利（85%）、芬兰（85%）、澳大利亚-新西兰（80%）和美国（77%）的 DD KT 比例较高。LD的5年移植物存活率最高的国家是韩国（95%）、新加坡（94%）、意大利（93%）、芬兰（93%）和日本（93%），而DD的5年移植物存活率最高的国家是韩国（93%）、意大利（88%）、日本（86%）和新加坡（86%）。有关 KT 的共同问题是获取途径以及 LD 和 DD 数量有限。长期存活率的关键问题是供体和受体的年龄增长、受体合并症增加以及移植后事件，如肾脏的同种免疫损伤、感染、癌症和治疗依从性不佳：结论：随着需求的不断增加，有必要采取统一的方法来改善与 KT 相关的问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation 医学-免疫学

CiteScore

8.50

自引率

11.30%

发文量

1906

审稿时长

1 months

期刊介绍： The official journal of The Transplantation Society, and the International Liver Transplantation Society, Transplantation is published monthly and is the most cited and influential journal in the field, with more than 25,000 citations per year. Transplantation has been the trusted source for extensive and timely coverage of the most important advances in transplantation for over 50 years. The Editors and Editorial Board are an international group of research and clinical leaders that includes many pioneers of the field, representing a diverse range of areas of expertise. This capable editorial team provides thoughtful and thorough peer review, and delivers rapid, careful and insightful editorial evaluation of all manuscripts submitted to the journal. Transplantation is committed to rapid review and publication. The journal remains competitive with a time to first decision of fewer than 21 days. Transplantation was the first in the field to offer CME credit to its peer reviewers for reviews completed. The journal publishes original research articles in original clinical science and original basic science. Short reports bring attention to research at the forefront of the field. Other areas covered include cell therapy and islet transplantation, immunobiology and genomics, and xenotransplantation.