亲属活体供肾肾体积与受体体表面积比值对早期移植肾功能的影响

谷东风; 赵云峰; 苗书斋; 曲青山

doi:10.3969/j.issn.1674-7445.2018.03.008

亲属活体供肾肾体积与受体体表面积比值对早期移植肾功能的影响

doi: 10.3969/j.issn.1674-7445.2018.03.008

450003 郑州人民医院器官移植中心

基金项目:

郑州市科技攻关计划项目 20150075

详细信息

作者简介:
谷东风，男， 1979 年生，主治医师，研究方向为慢性移植物肾病的发病机制， Email： dongfenggu@hotmail.com

通讯作者:
Qu Qingshan, Email: quqingshan20020624@163.com

中图分类号: R617
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出版历程
- 收稿日期: 2018-03-10
- 网络出版日期: 2021-01-19
- 刊出日期: 2018-05-15

Effect of the ratio of living related donor renal volume to recipient body surface area on early function of transplanted kidney

Organ Transplantation Center, the People' s Hospital of Zhengzhou, Zhengzhou 450003, China

摘要

摘要: 目的探讨亲属活体供肾肾体积（RV）与受体体表面积（BSA）比值（RV/BSA）与术后早期移植肾功能的关系。方法回顾性分析行亲属活体肾移植术的120对供、受体的临床资料。根据RV/BSA将受体分为A组（RV/BSA < 65.33 mL/m²），B组（RV/BSA为65.33~76.49 mL/m²），C组（RV/BSA为76.50~96.96 mL/m²），D组（RV/BSA > 96.96 mL/m²）。比较4组受体术后估算肾小球滤过率（eGFR），分析RV/BSA与受体术后6、12个月eGFR的相关性。结果 A组术后6个月eGFR明显低于B组、C组和D组（t=2.313，2.947，5.903；均为P < 0.05）。A组术后12个月eGFR亦明显低于B组、C组和D组（t=2.189，2.433，2.909；均为P < 0.05）。RV/BSA与受体术后6、12个月的eGFR均存在相关性（均为P < 0.05）。结论 RV/BSA与亲属活体肾移植术后早期移植肾功能密切相关。
- 亲属活体肾移植 /
- 移植肾 /
- 肾体积（RV） /
- 体表面积（BSA） /
- 估算肾小球滤过率（eGFR） /
- 慢性肾脏病
Abstract: Objective To investigate the relationship between the ratio of living related donor renal volume (RV) to recipient body surface area (BSA) (RV/BSA) and early postoperative function of transplanted kidney. Methods Clinical data of 120 pairs of donors and recipients undergoing living related renal transplantation were retrospectively analyzed. According to the RV/BSA ratio, the recipients were divided into group A (RV/BSA < 65.33 mL/m²), group B (RV/BSA 65.33~76.49 mL/m²), group C (RV/BSA 76.50~96.96 mL/m²) and group D (RV/BSA > 96.96 mL/m²). The postoperative estimated glomerular filtration rate (eGFR) of recipients was compared among 4 groups. The correlation between the RV/BSA and eGFR of recipients at postoperative 6 and 12 months was analyzed. Results The eGFR at postoperative 6 month in group A was significantly lower than that in groups B, C and D (t=2.313, 2.947, 5.903; all P < 0.05). The eGFR at postoperative 12 month in group A was also significantly lower than that in groups B, C and D (t=2.189, 2.433, 2.909; all P < 0.05). The RV/BSA was significantly correlated with the eGFR of recipients at postoperative 6 and 12 months (all P < 0.05). Conclusions RV/BSA is intimately correlated with the early function of transplanted kidney after living related renal transplantation.
- Living related renal transplantation /
- Transplanted kidney /
- Renal volume (RV) /
- Body surface area (BSA) /
- Estimated glomerular filtration rate (eGFR) /
- Chronic kidney disease

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图 1 各组受体肾移植术后6、12个月eGFR的比较

与A组比较，^aP < 0.05

Figure 1. Comparison of eGFR of recipients among each group at 6 and 12 month after renal transplantation

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参考文献(18)

[1]	GU DF, SHI YL, CHEN YM, et al. Prevalence of chronic kidney disease and prediabetes and associated risk factors: a community-based screening in Zhuhai, Southern China[J]. Chin Med J (Engl), 2013, 126(7): 1213-1219. https://www.ncbi.nlm.nih.gov/pubmed/23557546
[2]	VIJAYAN A, YANO M, NARRA VR, et al. The effect of donor kidney volume on recipient outcomes: "dose" matters[J]. Transplantation, 2013, 95(7): e46. DOI: 10.1097/TP.0b013e3182865624.
[3]	LENTINE KL, KASISKE BL, LEVEY AS, et al. KDIGO clinical practice guideline on the evaluation and care of living kidney donors[J]. Transplantation, 2017, 101(8S Suppl 1): S1-S109. DOI: 10.1097/TP.0000000000001769.
[4]	DANOVITCH GM, HARIHARAN S, PIRSCH JD, et al. Management of the waiting list for cadaveric kidney transplants: report of a survey and recommendations by the Clinical Practice Guidelines Committee of the American Society of Transplantation[J]. J Am Soc Nephrol, 2002, 13(2): 528-535. http://jasn.asnjournals.org/content/13/2/528.long
[5]	FICK-BROSNAHAN GM, BELZ MM, MCFANN KK, et al. Relationship between renal volume growth and renal function in autosomal dominant polycystic kidney disease: a longitudinal study[J]. Am J Kidney Dis, 2002, 39(6): 1127-1134. doi: 10.1053/ajkd.2002.33379
[6]	LEVEY AS, BOSCH JP, LEWIS JB, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. modification of diet in Renal Disease Study Group[J]. Ann Intern Med, 1999, 130(6): 461-470. doi: 10.7326/0003-4819-130-6-199903160-00002
[7]	EKNOYAN G, LEVIN N. NKF-K/DOQI clinical practice guidelines: update 2000. foreword[J]. Am J Kidney Dis, 2001, 37(1 Suppl 1): S5-S6.
[8]	MILES AM, SUMRANI N, JOHN S, et al. The effect of kidney size on cadaveric renal allograft outcome[J]. Transplantation, 1996, 61(6): 894-897. doi: 10.1097/00007890-199603270-00009
[9]	KASISKE BL, SNYDER JJ, GILBERTSON D. Inadequate donor size in cadaver kidney transplantation[J]. J Am Soc Nephrol, 2002, 13(8):2152-2159. doi: 10.1097/01.ASN.0000024564.22119.3D
[10]	LEE JH, WON JH, OH CK. Impact of the ratio of graft kidney volume to recipient body surface area on graft function after live donor kidney transplantation[J]. Clin Transplant, 2011, 25(6): E647-E655. DOI: 10.1111/ j.1399-0012.2011.01502.x.
[11]	GIRAL M, FOUCHER Y, KARAM G, et al. Kidney and recipient weight incompatibility reduces long-term graft survival[J]. J Am Soc Nephrol, 2010, 21(6): 1022-1029. DOI: 10.1681/ASN.2009121296.
[12]	LENTINE KL, MANDELBROT D. Moving from intuition to data: building the evidence to support and increase living donor kidney transplantation[J]. Clin J Am Soc Nephrol, 2017, 12(9): 1383-1385. DOI: 10.2215/ CJN.07150717.
[13]	LENTINE KL, KASISKE BL, LEVEY AS, et al. Summary of Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline on the evaluation and care of living kidney donors[J]. Transplantation, 2017, 101(8): 1783-1792. DOI: 10.1097/ TP.0000000000001770.
[14]	KEITH DS, VRANIC G, NISHIO-LUCAR A. Graft function and intermediate-term outcomes of kidney transplants improved in the last decade: analysis of the United States kidney transplant database[J]. Transplant Direct, 2017, 3(6): e166. DOI: 10.1097/ TXD.0000000000000654.
[15]	JINFENG L, JIA L, TAO G, et al. Donor kidney glomerular filtration rate and donor/recipient body surface area ratio influence graft function in living related kidney transplantation[J]. Ren Fail, 2015, 37(4): 576-581. DOI: 10.3109/0886022X.2015.1007805.
[16]	JULURU K, ROTMAN JA, MASI P, et al. Semiautomated CT-based quantification of donor kidney volume applied to a predictive model of outcomes in renal transplantation[J]. AJR Am J Roentgenol, 2015, 204(5): W566-W572. DOI: 10.2214/AJR.14.13454.
[17]	NARASIMHAMURTHY M, SMITH LM, MACHAN JT, et al. Does size matter? kidney transplant donor size determines kidney function among living donors[J]. Clin Kidney J, 2017, 10(1):116-123. DOI: 10.1093/ckj/ sfw097.
[18]	S R I T H O N G K U L T, P R E M A S AT H I A N N, VONGWIWATANA A, et al. Predictive model for the optimal glomerular filtration rate in living kidney transplant recipients[J]. Transplant Proc, 2014, 46(2):469-473. DOI: 10.1016/j.transproceed.2013.11.096.