亲属活体肾移植术后肾功能延迟恢复的影响因素  

Influencing factors of delayed graft function after living relative kidney transplantation

作　　者：姚芝玲 李珍[1] YAO Zhiling;LI Zhen(Department of Organ Transplantation,The First Affiliated Hospital of Kunming Medical University,Kunming 650000,China)

机构地区：[1]昆明医科大学第一附属医院器官移植科,昆明650000

出　　处：《肾脏病与透析肾移植杂志》2023年第6期540-545,共6页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项资金项目(202201AY070001-080);云南省技术创新人才培养对象项目(202305AD160007)。

摘　　要：目的:回顾性分析影响亲属活体肾移植术后肾功能延迟恢复(DGF)的危险因素。方法:选取2015年1月至2021年12月期间于昆明医科大学第一附属医院收治的205对接受亲属活体肾移植的供者和受者,收集并分析其临床资料,包括受者民族、供受者民族匹配情况、性别、年龄、血型是否相同、群体反应性抗体、补体依赖的细胞毒性试验、人类白细胞抗原匹配个数、透析时间、是否合并高血压;供者性别、年龄、术前肌酐水平、供肾肾小球滤过率(GFR)、是否合并高血压、供/受者体表面积比值、冷热缺血时间、慢性肾衰竭发生的病因。采用单因素和多因素Logistic回归分析DGF危险因素。结果:本组亲属活体肾移植术受者DGF的发生率为31.21%,单因素分析显示,受者民族、补体依赖的细胞毒性试验、供肾GFR、供者是否合并高血压、供/受者体表面积比值、冷缺血时间组间差异均有统计学意义(P<0.05);纳入多因素回归分析后表明,受者为少数民族(OR=4.386,P=0.003)、供/受者体表面积比值<1(OR=2.611,P=0.033)、供肾GFR<40 mL/(min·1.73m^(2))(OR=9.725,P<0.001)是直接影响DGF发生的独立危险因素。结论:少数民族受者、供/受者体表面积比值和供肾GFR低是影响DGF重要因素。Objective:Objective To analyze retrospectively the risk factors of delayed graft function(DGF)after living relative kidney transplantation.Methodology:205 pairs of donors and recipients receiving kinship living kidney transplantation admitted to our hospital from January 2015 to December 2021 were included in the study,and their clinical data were collected and analyzed.Including the matching of donor and recipient nationality,recipient nationality,gender,age,blood type,population reactive antibody,complement-dependent cytotoxicity,matching number of human leukocyte antigen,dialysis time,concomitant hypertension;Donor sex,age,preoperative creatinine level,donor glomerular filtration rate,concomitant hypertension,donor/recipient surface area ratio,warm and cold ischemia,and etiology of chronic renal failure.Univariate and multivariate logistic regression analysis were used to investigate the risk factors of DGF.Results:The incidence of DGF in relative living kidney transplantation recipients was 31.21%.Univariate analysis showed that:There were statistically significant differences in recipient nationality,complement-dependent cytotoxicity,donor glomerular filtration rate,donor concomitant hypertension,donor/recipient body surface area ratio,and cold ischemia time among groups(P<0.05).Multivariate regression analysis showed that:Minority recipients(OR=4.386,P=0.003),donor/recipient body surface area ratio<1(OR=2.611,P=0.033)and donor GFR<40 mL/(min·1.73m^(2))(OR=9.725,P<0.001)were independent risk factors that directly affected the development of DGF.Conclusion:Minority recipients,donor/recipient body surface area ratio<1 and donor GFR<40 mL/(min·1.73 m^(2))are important factors affecting DGF.

关 键 词：亲属活体肾移植 肾功能延迟恢复 危险因素 

分 类 号：R699.2[医药卫生—泌尿科学]