活体肾移植供肾肾小球滤过率对术后移植肾功能恢复的影响

Influence of glomerular filtration rate of living donor on recovery of graft function after transplantation

    摘要
  • 摘要:
      目的  探讨活体肾移植供肾肾小球滤过率(GFR)对术后移植肾功能恢复的影响。
      方法  回顾性分析2009年至2013年在昆明医科大学第一附属医院器官移植中心接受活体供肾移植的108对供受者的临床资料。按供肾GFR数值大小将研究对象分为G1组(GFR < 40 ml/min)、G2组(GFR 40~45 ml/min)、G3组(GFR 46~50 ml/min)及G4组(GFR > 50 ml/min)。比较各组受者术后1周、2周、3周、1个月、3个月、6个月及1年的血清肌酐(Scr)的变化情况, 以及术后1年的人及肾存活情况。
      结果  与G1组比较, G2、G3、G4组术后2周、3周、1个月的Scr值较低, 差异有统计学意义(均为P < 0.05), 术后1年内人、肾存活情况, G1组超急性排斥反应致移植肾失功1例、重症肺部感染死亡1例; G2组因急性排斥反应导致移植肾失功1例; G3组死于重症肺部感染者1例; G4组1例死于重症肺部感染; 其余患者在随访期间人、肾均存活。
      结论  活体肾移植供肾GFR值低对术后移植肾早期(1个月内)肾功能恢复有一定影响。

     

    Abstract:
      Objective  To investigate the influence of glomerular filtration rate (GFR) of living donor on recovery of graft function after transplantation.
      Methods  Clinical data of 108 pairs of donors and recipients undergoing living donor renal transplantation at the Organ Transplantation Center of First Affiliated Hospital of Kunming Medical University from 2009 to 2013 were retrospectively studied. The objects were divided into G1 group(GFR < 40 ml/min), G2 group(GFR 40~45 ml/min), G3 group(GFR 46~50 ml/min)and G4 group (GFR > 50 ml/min) according to GFR of the donor kidneys. Changes in serum creatinine (Scr) at 1 week, 2 weeks, 3 weeks, 1 month, 3 months, 6 months and 1 year after transplantation as well as survival conditions of patient and kidney within 1 year after transplantation of each group were compared.
      Results  Compared with G1 group, Scr at 2 weeks, 3 weeks, 1 month after transplantation was lower in G2 group, G3 group and G4 group, and the difference had statistical significance (all in P < 0.05). As for survival conditions of patient and kidney within 1 year after transplantation, one patient in G1 group developed graft failure due to hyperacute rejection and one patient in G1 group died of severe pulmonary infection. One patient in G2 group developed graft failure due to acute rejection. One patient in G3 group died of severe pulmonary infection. One patient in G4 group died of severe pulmonary infection. Other patients and grafts survived during the follow-up.
      Conclusions  Low GFR of living kidney donor has certain influence on recovery of graft function in the early stage (within one month) after renal transplantation.

     

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