Oh Chang-Kwon, Lee Byung Mo, Jeon Kyung Ock, Kim Hyun Jung, Pelletier Shawn J, Kim Soon Il, Kim Yu Seun
Department of Surgery, Ajou University School of Medicine, Yeongtong-Gu, Suwon, Korea.
Clin Transplant. 2006 Mar-Apr;20(2):163-70. doi: 10.1111/j.1399-0012.2005.00459.x.
Kidney donation from female donors to male recipients has been reported to be associated with decreased allograft survival. Whether there was a gender-related inadequacy between donor nephron supply and recipient functional demand was investigated in this study. One hundred ninety-five living donor kidney transplant recipients that had neither ischemic injury, episode of rejection, nor any complication were included. Weights and heights of both donors and recipients were recorded to calculate body surface area, lean body weight, and body mass index. The donated kidney was weighed just after cold flush, and the recipient's serum creatinine (Scr) was measured on a daily basis post-operatively. When the recipient's Scr reached the baseline, a 24-h urine was collected for the amount of proteinuria (Upr), creatinine excretion (Ucr) and creatinine clearance (Ccr) calculation. The effect of donor and recipient gender was analysed by independent sample t-test. On average, male donors and recipients were heavier and taller than females. However, the mass of kidneys donated from men and women were not statistically different. The gender-related differences in post-transplant Scr and Ucr of recipients were associated with the differences in the parameters of metabolic demands of recipients rather than with the weight of implanted kidney (renal mass supply) or with pre-operative renal functions of donors (functional supply). The early graft function is not determined by donor gender. The effect of recipient gender on the graft function depends on the metabolic demands, which are higher in male recipients.
据报道，女性供体向男性受体捐献肾脏与移植肾存活率降低有关。本研究调查了供体肾单位供应与受体功能需求之间是否存在与性别相关的不匹配。纳入了195例既无缺血损伤、排斥反应发作，也无任何并发症的活体供肾移植受者。记录供体和受体的体重和身高，以计算体表面积、瘦体重和体重指数。在冷灌注后立即称取捐献肾脏的重量，并在术后每天测量受体的血清肌酐（Scr）。当受体的Scr达到基线时，收集24小时尿液以计算蛋白尿（Upr）量、肌酐排泄量（Ucr）和肌酐清除率（Ccr）。通过独立样本t检验分析供体和受体性别的影响。平均而言，男性供体和受体比女性更重、更高。然而，男性和女性捐献肾脏的质量没有统计学差异。受体移植后Scr和Ucr的性别差异与受体代谢需求参数的差异有关，而与植入肾脏的重量（肾质量供应）或供体术前肾功能（功能供应）无关。早期移植肾功能不由供体性别决定。受体性别对移植肾功能的影响取决于代谢需求，男性受体的代谢需求更高。
