供/受体体表面积比值在儿童供肾移植中的作用及应用  

Impact and application of donor/recipient body surface area on kidney transplantation from pediatric donors

作　　者：彭志谭 成柯[1] 赵于军[1] 刘炼[1] 王强[1] 叶启发[1] 

机构地区：[1]中南大学湘雅三医院,湖南长沙410013

出　　处：《中国现代医学杂志》2017年第11期78-82,共5页China Journal of Modern Medicine

摘　　要：目的研究供/受体体表面积比值(D/R BSA)在心脏死亡儿童供体单肾移植中的作用,并对其应用进行初步探讨。方法回顾性研究该中心自2010~2014年开展的13例供体年龄为2~18岁的心脏死亡儿童供体单肾移植。根据D/RBSA比值将患者分成两组:A组D/R BSA<0.8;B组D/R BSA≥0.8。比较不同分组间供受体基本资料、术后早期并发症、术后1年内肾小球滤过率(e-GFR)及移植肾存活情况的差异。结果两组间供体性别、年龄、体重、身高、体表面积、原发病及术前肌酐等差异无统计学意义(P>0.05)。两组受者术后早期并发症的发生率比较差异无统计意义(P>0.05)。两组术后1、3、6及12个月的肾小球滤过率的平均值分别为(63.2±5.0)vs(74.0±7.6)(P=0.008);(66.2±4.9)vs(75.8±5.9)(P=0.004);(69.0±4.8)vs(79.0±6.3)(P=0.004);(69.4±7.9)vs(79.2±8.4)(P=0.033)。A组术后1年移植肾存活率为62.5%,B组移植肾存活率为94.4%;B组高于A组,差异有统计学意义(P=0.042)。结论当儿童供体的年龄>2岁时,D/R BSA比值>0.8有利于心脏死亡儿童供体单肾移植术后移植肾功能的恢复,并且有助于受者的合理选择。Objective To evaluate the utility of donor/recipient body surface area （D/R BSA, BSA of donor/ BSA of recipient） by studying the impact of D/R BSA on kidney transplantations from pediatric donors. Methods We retrospectively analyzed 26 cases of kidney transplantations from pediatric donors whose age ranged from 2 to 18 years old, which were performed in our center from 2010 to 2014. Patients were divided into two groups based on D/R BSA： group A 〈 0.8, group B ≥ 0.8. All recipients received a single kidney. Demographics of donors and recipients, early postoperative complications, estimated glomerular filtration rate （e-GFR） and short-term graft survival （≤ 1 year） were compared between each group to evaluate the impact of D/R BSA on kidney transplantations from pediatric donors. Results All demographics and early postoperative complications of group A were similar to those of group B （P 〉 0.05）. E-GFR in group A and group B at one, three, six and twelve months post transplantation were： （63.2 ±5.0） vs （74.0 ± 7.6）, P= 0.008; （66.2 ±4.9） vs （75.8 ± 5.9）, P = 0.004; （69.0 ± 4.8） vs （79.0± 6.3）, P = 0.004; （69.4 ± 7.9） vs （79.2 ± 8.4）, P = 0.033. Short-term graft survival of group A was inferior to that of group B （62.5% vs 94.4%, P = 0.042）. Conclusions We conclude that recipients with high D/R BSA are more likely to have better graft function when the age of pediatric donor is more than 2 years old. It is possible to make optimal allocation of pediatric donor kidneys on the basis of D/R BSA （≥ 0.8）.

关 键 词：心脏死亡 捐献 儿童供体 肾移植 体表面积 

分 类 号：R617[医药卫生—外科学]