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頁籤選單縮合
題名 | Should Patients Older Than 55 Years of Age Receive Renal Transplantation?=55歲以上之腎衰竭老年人應否接受腎移植? |
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作者 | 陳煜; 朱聖賢; 江仰仁; 陳孝文; 陳志碩; 莊正鏗; Chen, Yu; Chu, Sheng-hsien; Chiang, Yang-jen; Chen, Hsiao-wen; Chen, Chih-shou; Chuang, Cheng-keng; |
期刊 | 中華民國泌尿科醫學會雜誌 |
出版日期 | 19990600 |
卷期 | 10:2 1999.06[民88.06] |
頁次 | 頁57-61 |
分類號 | 416.273 |
語文 | eng |
關鍵詞 | 老年人; 腎移植術; Elderly; Renal transplantation; |
中文摘要 | 從1981年到1997年,共有14位55歲以上之老年患者在本院接受腎移植術。因 為腎衰竭而需要接受治療的老年人不斷增加,且移植器官之短缺,造成這類病人在治療上之 巨大挑戰。本組病例中有6例是移植腎功能正常的患者死亡(42.9%),其中一例是因心臟衰竭 死亡,另一例是因氣喘病發死亡,其餘四例是死於肝癌(66.7%)(其中各有一例併發膀胱癌或 菌血症)。另一方面,急性排斥和慢性排斥各造成一例移植腎喪失。一,二,三和五年之病人 /腎存活率分別為100%/92.9%,81.8%/76.0%,70.1%/65.1%,和46.7%/43.4%。有二例病人感 染巨細胞病毒,但並無因此造成死亡或移植腎喪失。有二例病人併發泌尿道感染,且其中一 位合併輸尿管腫瘤。患者之帶腎死亡是移植失敗之重要原因,且惡性腫瘤是導致患者死亡的 主要原因。本研究認為55歲以上之老年患者經嚴格挑選可安全成功地接受腎移植術,但惡性 腫瘤之定期追蹤是十分必要的,特別在肝炎帶原者更是如此。 |
英文摘要 | In the period from 1981 to 1997, a total of 14 patients older than 55 years received a renal transplantation at our hospital. Therapy of end-stage renal disease (ESRD) in the elderly is characterized by tremendous challenges because of the progressive increase in the proportion of elderly requiring ESRD therapy worldwide and the shortage of donor organ. Mortality occurred in 6 of our series with functioning grafts (42.9%). One patient was lost due to heart failure and another from asthma attack. Hepatocellular carcinoma was the main cause of death in 4 (66.7%), two of them combined with bladder tumor or sepsis each. On the other hand, another two grafts loss without death were attributed by acute and chronic rejection each. Patient survival at 1, 2, 3, and 5 years was 100%, 81.8%, 70.1%, and 46.7% and the graft survival 92.9%, 76.0%, 65.1%, and 43.4%, respectively. Two patients developed CMV infection (CMV pneumonitis and CMV chorioido-retinitis) with no death or graft loss. Two patients complicated with urinary tract in- fection and one with ureter tumor. Death with functioning grafts was the main cause of trans- plantation failure. Malignancy was the most prominent cause of death in our series. Our study demonstrates that cadaver renal transplantation can be performed successfully and safely in se- lected patients who are older than 55 years but regular follow-up for malignancy screening is necessary especially in hepatitis B and/or C carriers. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。