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ニッタ コウサク
NITTA Kousaku
新田 孝作 所属 医学部 医学科（東京女子医科大学病院） 職種 客員教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読なし |
| 表題 | Survival benefit of living donor kidney transplantation in patients on hemodialysis. |
| 掲載誌名 | 正式名：Clinical and experimental nephrology 略 称：Clin Exp Nephrol ISSNコード：14377799/13421751 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 28(2),pp.165-174 |
| 著者・共著者 | Goto Shunsuke, Fujii Hideki, Mieno Makiko, Yagisawa Takashi, Abe Masanori, Nitta Kosaku, Nishi Shinichi |
| 発行年月 | 2024/02 |
| 概要 | BACKGROUND:Donors bravely donate their kidneys because they expect that living donor kidney transplantation (LKT) confers benefits to recipients. However, the magnitude of the survival benefit of LKT is uncertain.METHODS:This prospective cohort study used two Japanese nationwide databases for dialysis and kidney transplantation and included 862 LKT recipients and 285,242 hemodialysis (HD) patients in the main model and 5299 LKT recipients and 151,074 HD patients in the supplementary model. We employed time-dependent model in the main model and assessed the hazard ratio and the difference in the restricted mean survival time (RMST) between LKT recipients and HD patients. In the main analysis of the main model (LKT, N = 675; HD, N = 675), we matched LKT recipients with HD patients by age, sex, dialysis vintage, and cause of renal failure and excluded HD patients with dementia or performance status grades 2, 3, or 4.RESULTS:The median observational period was 8.00 (IQR 3.58-8.00) years. LKT was significantly associated with a lower risk of mortality (hazard ratios (95% confidence interval (CI)), 0.50 (0.35-0.72)) and an increase in life expectancy (7-year RMST differences (95% CI), 0.48 (0.35-0.60) years) compared with HD. In subgroup analysis, the survival benefit of LKT was greater in female patients than in male patients in the Cox model; whereas older patients gained longer life expectancy compared with younger patients.CONCLUSIONS:LKT was associated with better survival benefits than HD, and the estimated increase in life expectancy was 0.48 years for 7 years. |
| DOI | 10.1007/s10157-023-02417-y |
| PMID | 37864680 |