高龄供者血清Klotho水平预测受者术后移植肾功能状态的临床研究  

Clinical study of value of serum Klotho level of elderly donors in predicting postoperative renal graft function in recipients

作　　者：王健富[1] 邓庚国 朱春丽[1] 李琴[1] 周结学[1] 蒙善东[1] 申升[1] 王晓[1] 马娟[1] 刘东[1] Wang Jianfu;Deng Gengguo;Zhu Chunli;Li Qin;Zhou Jiexue;Meng Shandong;Shen Sheng;Wang Xiao;Ma Juan;Liu Dong(Department of Organ Transplantation,Guangdong Second Provincial People's Hospital,Guangzhou 510317,China)

机构地区：[1]广东省第二人民医院器官移植科

出　　处：《器官移植》2019年第4期439-442,共4页Organ Transplantation

基　　金：广东省科技计划项目(2014A020212680);广州市科技计划项目(201707010366)

摘　　要：目的探讨高龄供者血清Klotho水平预测受者移植肾功能的可行性。方法选取16例高龄供者和相应27例肾移植受者的临床资料。观察肾移植受者的一般情况。检测高龄供者器官获取手术当日血清Klotho和血清肌酐(Scr)水平。检测肾移植受者术后1、3、12个月的Scr水平,计算估算肾小球滤过率(eGFR),分析供者血清Klotho水平与受者术后移植肾功能的相关性。结果肾移植术中的冷缺血时间为(649±245)min,受者移植物功能延迟恢复(DGF)发生率为26%,急性排斥反应发生率为7%。高龄供者血清Klotho水平为537(245~793)pg/mL,Scr水平为(164±62)μmol/L。受者术后1、3、12个月的Scr水平分别为(136±47)、(132±43)、(133±46)μmol/L,相应的eGFR分别为(52±20)、(52±19)、(53±21)mL/(min·1.73m2)。高龄供者血清Klotho水平与受者术后1个月移植肾功能呈负相关(P<0.05)。血清Klotho水平预测术后1个月移植肾功能不全的灵敏度和特异度分别为0.909和0.769。结论高龄供者术前血清Klotho水平对受者术后1个月移植肾功能具有预测价值。Objective To explore the feasibility of serum Klotho level in the elderly donors to predict the renal graft function in the recipients. Methods Clinical data of 16 elderly donors and 27 recipients undergoing renal transplantation were collected. The general status of the recipients was observed. The levels of serum Klotho and serum creatinine (Scr) in the elderly donors were measured on the day of renal transplantation. The Scr levels in the recipients were measured at postoperative 1, 3 and 12 months respectively. The estimated glomerular filtration rate (eGFR) was calculated. The correlation between the serum Klotho level of the donors and postoperative graft function of the recipients was analyzed. Results The cold ischemia time during renal transplantation was (649±245) min. The incidence rate of delayed graft function (DGF) was 26%. The incidence rate of acute rejection was 7%. In the elderly donors, the serum Klotho level was 537 (245-793) pg/mL and the Scr level was (164±62)μmol/L. At postoperative 1, 3 and 12 months, the Scr levels in the recipients were (136±47),(132±43) and (133±46)μmol/L, respectively. The corresponding eGFR was (52±20),(52±19) and (53±21) mL/(min?1.73m2), respectively. The serum Klotho level in the elderly donors was negatively correlated with the renal graft function at postoperative 1 month in the recipients (P<0.05). The sensitivity and specificity of serum Klotho level in predicting the renal graft insufficiency at postoperative 1 month were 0.909 and 0.769. Conclusions The preoperative serum Klotho level in the elderly donors have predictive value for renal graft function in the recipients at postoperative 1 month.

关 键 词：肾移植 KLOTHO 高龄供者 边缘供肾 移植肾功能 血清肌酐 受试者工作特征(ROC)曲线 

分 类 号：R617[医药卫生—外科学]