| 特集名 | 透析スタッフにとっての腎移植―直面する臨床的課題 | |
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| 題名 | 腎移植前後の患者管理（7）高齢腎不全患者における腎移植 | |
| 発刊年月 | 2017年 12月 | |
| 著者 | 豊田 麻理子 | 熊本赤十字病院腎臓内科 |
| 【 要旨 】 | 腎不全患者の高齢化に伴い，高齢者で移植を受ける患者も増えてきている．高齢者における腎移植の成績は若年者と遜色なく，生命予後，QOL改善の点から移植は高齢腎不全患者に対しても腎代替療法の選択肢として考慮されるべきである． 高齢レシピエントでは，①急性拒絶反応が少ない，②感染症の合併が多い，③移植腎喪失の原因としてdeath with functioning graftが多い，という特徴がある．術前の十分な評価とおもな死因である感染症や心血管合併症の予防・早期介入によって，高齢者にとっても移植は満足度の高い腎代替療法となる． |
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| Theme | Kidney transplantation for dialysis room staff -- Recent clinical issues | |
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| Title | Renal transplantaion in elderly patients with end-stage renal disease | |
| Author | Mariko Toyoda | Department of Nephrology, Japanese Red Cross Kumamoto Hospital |
| [ Summary ] | With the aging of patients with renal failure, the number of elderly people receiving transplantation has also increased. The results of renal transplantation in elderly people are comparable to those of young people. From the viewpoints of life prognosis and quality of life improvement, renal transplantation should be considered as an option for RRT in elderly patients with end-stage renal disease. In older recipients, the following characteristics are observed : 1) acute rejection is fewer, 2) infectious complications are more frequent, and 3) the major cause of graft loss is death with functioning grafts. Due to a careful evaluation before transplantation and prevention and early treatment of infection and cardiovascular complications, which are the major causes of death, transplantation has become a preferred RRT for elderly patients. |
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