BÖBREK NAKLİNDE MARJİNAL DONÖR KULLANIMINA AİT UZUN DÖNEM SONUÇLARIMIZ VE STANDART KRİTERLİ DONÖRLERLE KARŞILAŞTIRILMASI

Giriş: Çalışmamızın amacı marjinal donör kullanılarak yapılan böbrek nakli hastalarımızın sonuçlar ını değerlen- dirmek ve standart kriterli donör (SKD) kullanılan nakillerle karşılaştırmaktır. Gereç ve Yöntem: Sağlık Bilimleri Üniversitesi, İzmir Bozyaka Eğitim ve Araştırma Hastanesi’nde Şubat 2010 ve Şubat 2020 yılları arasında kadavradan böbrek nakli olmuş olgular marjinal donör (Grup 1) ve standart kriterli donörler (Grup 2) olmak üzere iki gruba ayrıldı. Beyin ölümü gerçekleşmiş 60 yaş tüm donörler ya da 50-59 yaş arası donörlerden (a) Hipertansiyon öyküsü, (b) Beyin ölümü nedeni olarak serebro-vasküler olay (SVO) geçirmiş olması, (c) Serum Kreatinin de ğeri> 1.5mg/dl kriterlerinden en az ikisini karşılayanlar marjinal donör olarak kabul edildi. Bu kriterleri karşılamayan tüm kadaverik donörler SKD olarak kategorize edildi. Bulgular: 245 olgu çalışmaya dahil edildi. Hastaların ya ş ortalaması 44 10yıl, ortalama takip süresi 57 32 ay, kadın cinsiyet oran ı %37 idi. Grup 1’deki hasta sayısı 54(%22), Grup2’deki hasta sayısı 191(%78) idi. Marjinal donör grubundaki nakil hastalarının SKD grubuna göre bazal (44 16 vs 56.5 23 mL/min/1.72m², p=0.001), 3.ay (49 15 vs 59.8 22 mL/min/1.72m², p=0.004), 6.ay (51 16 vs 62.9 26 mL/min/1.72m², p= 0.006), 12.ay (51 15 vs 63.9 22 mL/min/1.72m², p=0.001) ve son poliklinik kontrol (46 19 vs 57.8 24 mL/min/1.72m², p=0.001) glomerüler filtrasyon hızı (GFR) de ğerleri istatiksel olarak anlamlı şekilde daha düşük tespit edilmesine ra ğmen greft kayb ı (%12.9 vs %6.2, p=0.1) ve morta lite (%7.4 vs %8.3, p=0.81) oranlarını karşılaştırdığımızda anlamlı fark yoktu. Ayr ıca Kaplan-meier analizi sonucunda her iki grup arasında greft sa ğ kalımı(p=0.1) ve hasta sa ğ kalımı(p=0.8) arasında istatistiksel anlamlı fark saptanmadı. Sonuç:Marjinal donör kullanılan nakilli hastaların greft fonksiyonları,SKD greft nakilli hastalara göre daha düşük olmasına rağmen hasta ve graft sağ kalımı açısından karşılaştırılabilir düzeydedir.

THE LONG-TERM OUTCOMES OF KIDNEY TRANSPLANTATION FROM MARJINAL DONORS AND COMPARISON WITH STANDART CRITERIA DECEASED DONORS

Introduction: The aim of this study to compare the clinical outcomes of adult kidney transplants from expanded criteria deceased donors (ECD) with those from concurrent standard criteria deceased donors (SCD). Materials and methods:Kidney transplants from deceased donors between February 2010 and February 2020 at the University of Health Sciences, Izmir Bozyaka Education and Research Hospital were considered for the study. Deceased donor kidney grafts were classified as ECDs, if they met either of the following conditions: donor age equal to or more than 60 years or donor age 50 to 59 years, with at least two of the following criteria: serum creatinine more than 1.5 mg/dL, death due to cerebrovascular accident, or history of hypertension. SCD is defined as a donor who fails to meet the criteria for ECD. Results:A total of 245 cases were included in the study and the number of patiens with ECD was 54(%22). The mean age of the patients was 44 10 years, the mean follow-up period was 57 32 months, and the female gender ratio was 37%. Patients who received a transplant from ECDs had lower baseline GFR (44 16 vs 56.5 23 mL/min/1.72m², p=0.001), 3mo GFR (49 15 vs 59.8 22 mL/min/1.72m², p=0.004), 6mo GFR (51 16 vs 62.9 26 mL/min/1.72m², p= 0.006), 1year GFR (51 15 vs 63.9 22 mL/min/1.72m², p=0.001) and last control GFR (46 19 vs 57.8 24 mL/min/1.72m², p= 0.001).However, there were no significant differences in graft loss(%12.9 vs %6.2, p=0.1)and mortality(%7.4 vs %8.3, p=0.81) between the two groups. Also our Kaplan-Meier analysis showed that there is no differences in graft and patient survival(p=0.1, p= 0.8). Conclusion:Although ECD grafts had worse graft function, patient and graft survival was comparable with SCD grafts

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