横纹肌溶解症合并急性肾损伤供肾的临床应用  

Clinical application of donor kidney in rhabdomyolysis combined with acute kidney injury

作　　者：王建立 关兆杰 尹利华 张莉莉[1] 钱雷 刘杰[1] 牛玉坚 沈中阳[1] Wang Jianli;Guan Zhaojie;Yin Lihua;Zhang Lili;Qian Lei;Liu Jie;Niu Yujian;Shen Zhongyang(Organ Transplantation Department,Third Medical Center of PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第三医学中心器官移植研究所,北京100039

出　　处：《中华器官移植杂志》2018年第11期660-662,共3页Chinese Journal of Organ Transplantation

摘　　要：目的探讨横纹肌溶解症合并急性肾损伤(AKI)供者供肾移植的临床应用效果。方法回顾性分析2017年3月至2018年5月10例横纹肌溶解症供者及其14例供肾移植的临床资料。结果10例供者因横纹肌溶解症导致AKI。获取供肾前,10例供者的血肌酸激酶(CK)值为(14005±11894)U/L;7例血浆肌红蛋白>3000μg/L,3例为(2288±680)μg/L;乳酸脱氢酶(LDH)为(883±4531)U/L;血清肌酐值为(216±125)μmol/L。其中6例供者在获取供肾前接受了连续性肾脏替代疗法。14例肾移植受者中,6例术后发生移植肾功能恢复延迟(DGF),发生率为42.9%(6/14),维持时间(10±6.6)d(3~20d);随访3~15个月受者和移植肾均存活。术后1、3个月肾小球滤过率分别为(40.19±19.55)和(55.01±15.94)ml·min^-1·1.73m^-2。结论横纹肌溶解症合并AKI供者供肾移植后近期效果满意,但DGF发生率较高,远期效果有待进一步观察。Objective To investigate the clinical effect of donor kidneys in rhabdomyolysis(RM) combined with acute kidney injury(AKI).Methods A retrospective analysis was made on the clinical data of 10 donors with RM and 14 cases of renal transplantation from March 2017 to May 2018.Results AKI was caused by RM in 10 donors.Before harvesting the donor kidneys,blood creatine kinase(CK) level was (14 005.19±11 894.27) U/L in 10 donors,plasma myoglobin level was >3 000 μg/L in 7 cases,and that was (2 288±680)μg/L in 3 cases.LDH level was 883±453 IU/L and serum creatinine (Cr) value was (216.55±125)μmol/L.6 donors received continuous renal replacement therapy.Six patients with delayed renal function recovery (DGF) were treated with CRRT.The duration of GDF was 3-20 days,with an average of 10±6.6 days.All the patients were followed up for 3-15 months.The glomerular filtration rate was (40.19±19.55) ml·min·1.73 m^-2 and (55.01±15.94) ml·min·1.73 m^-2 at 1st and 3rd month after operation,respectively.Conclusion The incidence of DGF in donor kidneys with RM and AKI is high,and the short-term effect is satisfactory.The long-term effect needs to be further observed.

关 键 词：肾移植 供者 横纹肌溶解症 急性肾损伤 

分 类 号：R699.2[医药卫生—泌尿科学]