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可影响肾移植结果的危险因素。

Risk factors that can influence kidney transplant outcome.

作者信息

Parzanese I, Maccarone D, Caniglia L, Pisani F, Mazzotta C, Rizza V, Famulari A

机构信息

Centro Regionale per i Trapianti Regione Abruzzo-Regione Molise, L'Aquila, Italy.

出版信息

Transplant Proc. 2006 May;38(4):1022-3. doi: 10.1016/j.transproceed.2006.03.053.

Abstract

The survival and function of a kidney transplant are influenced by numerous immunological and nonimmunological factors. The aim of this study was to evaluate the role of a number of cadaveric donor parameters on transplanted kidney function, and in particular on the occurrence of delayed graft function (DGF) since DGF is one of the most important factors in long-term organ survival. This study looked at 143 patients who underwent kidney transplant of whom 32 displayed DGF. The creatinine levels in organ recipients, which were evaluated during a follow-up that ranged between 6 months and 4 years, were significantly higher among recipients who developed DGF after transplant (1.8 +/- 0.7 vs 1.4 +/- 0.4; P = .02). The following donor parameters were taken into consideration: history of diabetes and hypertension; creatinine levels; inotropie therapy; problems relating to hemodynamics (hypotension and/or cardiac arrest); and cold ischemia time. We observed that a donor history of hypertension (46.8% DGF vs 23.27% no DGF; P = .01) and high levels of donor creatinine prior to organ removal (1.9 +/- 1.2 mg/dL DGF vs 1.2 +/- 0.9 mg/dL no DGF; P = .007) were significant risk factors for DGF among kidney recipients. No significant differences were found for others factors between recipients with versus without DGF.

摘要

肾移植的存活及功能受众多免疫和非免疫因素影响。本研究旨在评估多个尸体供体参数对移植肾功能的作用,尤其是对移植肾功能延迟恢复(DGF)发生率的影响,因为DGF是长期器官存活的最重要因素之一。本研究观察了143例接受肾移植的患者,其中32例出现DGF。在6个月至4年的随访期间对器官受体的肌酐水平进行评估,移植后发生DGF的受体的肌酐水平显著更高(1.8±0.7 vs 1.4±0.4;P = 0.02)。考虑了以下供体参数:糖尿病和高血压病史;肌酐水平;血管活性药物治疗;与血流动力学有关的问题(低血压和/或心脏骤停);以及冷缺血时间。我们观察到,供体有高血压病史(发生DGF的比例为46.8%,未发生DGF的比例为23.27%;P = 0.01)以及器官切除前供体肌酐水平较高(发生DGF者为1.9±1.2mg/dL,未发生DGF者为1.2±0.9mg/dL;P = 0.007)是肾受体发生DGF的显著危险因素。在发生DGF和未发生DGF的受体之间,其他因素未发现显著差异。

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