GHÉP THẬN TỪ NGƯỜI HIẾN TẠNG SAU KHI CHẾT: TỶ LỆ SỐNG CÒN THẬN GHÉP VÀ BỆNH NHÂN

Abstract

Background: Deceased donors (DD) help expand the organ donation pool and are becoming a global trend in transplantation as the supply from living donors is insufficient to meet the demand. Research Objectives: To present the graft survival rate, patient survival rate, and factors influencing these survival rates. Research Methods: This is a retrospective, descriptive cohort study, which included cases that received kidneys from DDs from April 2008 to December 2021 at Cho Ray Hospital.  Results and discussion: The study included 27 DDs with a median age of 37, with males making up 88.8%. The median KDPI (Kidney Donor Profile Index) was 35%. There were 51 kidney recipients, with a median age of 37, 72.5% males, a body mass index of 20.9, a median dialysis duration of 39.3 months, with hemodialysis being the predominant treatment method. The median cold ischemia time was 7 hours and the warm ischemia time was 38 minutes. The main induction immunosuppressant drugs were IL-2 receptor inhibitors, constituting 64.7%, and the main maintenance immunosuppressant was tacrolimus (94.1%). The graft survival rates at 1-year, 3-years, and 5-years were sequentially 100%, 97.7%, and 95.1%. The patient survival rates at these intervals were 96.1%, 93.6%, and 93.6%. Significant factors affecting graft survival included: donor age over 60, KDPI over 80%, delayed graft function, acute rejection in the first year, and estimated glomerular filtration rate lower than 45 ml/min/1.73m² at one-month post-transplant. Significant factors affecting patient survival were: DD meeting the circulatory death criteria, recipients under 40 and 50 years of age, and delayed graft function. Conclusion: The study indicates that the graft and patient survival rates are comparable to international figures. Thus, using kidneys from DDs is feasible. However, given the limited sample size in the study, further research with a larger number of recipients is recommended.