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估计的供体肾小球滤过率是预测活体供肾受者移植肾功能的最重要的供体特征。

Estimated donor glomerular filtration rate is the most important donor characteristic predicting graft function in recipients of kidneys from live donors.

作者信息

Hawley Carmel M, Kearsley Jamie, Campbell Scott B, Mudge David W, Isbel Nicole M, Johnson David W, May Kylie, Preston John, Griffin Anthony, Wall Daryl, Burke John, McTaggart Steven J, Frohloff Gayle, Nicol David

机构信息

Department of Nephrology, Southern Clinical School, University of Queensland, Princess Alexandra Hospital, Brisbane, Qld, Australia.

出版信息

Transpl Int. 2007 Jan;20(1):64-72. doi: 10.1111/j.1432-2277.2006.00400.x.

Abstract

We hypothesized that predictors of outcome in live donor transplants were likely to differ significantly from deceased donor transplants, in which cold ischaemia time, cause of donor death and other donor factors are the most important predictors. The primary aim was to explore the independent predictors of graft function in recipients of live donor kidneys (LDK). Our secondary aim was to determine which donor characteristics are the most useful predictors. A retrospective analysis was undertaken of all patients receiving live donor (n = 206) renal transplants at our institution between 31 May 1994 and 15 October 2002. Twelve patients were excluded from the analysis. Follow-up was completed on all patients until graft loss, death or 22 November 2003. We explored predictors of Nankivell glomerular filtration rate (GFR) at 6 months by multivariate linear regression. In the 194 patients studied, the mean recipient 6-month Nankivell GFR was 59 +/- 15 ml/min/1.73 m(2). Independent predictors of recipient GFR in at 6 months were donor Cockcroft-Gault GFR (CrCl; beta 0.16; CI 0.13 to 0.29; P < 0.0001), steroid resistant rejection (beta-6.07; CI -12.05 to -0.09; P = 0.006) and delayed graft function (DGF) (beta-10.0; CI -19.52 to -0.49; P = 0.039). Renal function in an LDK transplant recipients is predicted by donor GFR, episodes of steroid resistant rejection and DGF. Importantly, donor Cockcroft-Gault GFR is the most important characteristic for predicting the recipient renal function.

摘要

我们推测,活体供体移植的预后预测因素可能与尸体供体移植有显著差异,在尸体供体移植中,冷缺血时间、供体死亡原因及其他供体因素是最重要的预测因素。主要目的是探讨活体供肾(LDK)受者移植肾功能的独立预测因素。次要目的是确定哪些供体特征是最有用的预测因素。对1994年5月31日至2002年10月15日在本机构接受活体供肾移植(n = 206)的所有患者进行了回顾性分析。12例患者被排除在分析之外。对所有患者进行随访直至移植肾失功、患者死亡或2003年11月22日。我们通过多变量线性回归探讨了6个月时Nankivell肾小球滤过率(GFR)的预测因素。在研究的194例患者中,受者6个月时的平均Nankivell GFR为59±15 ml/min/1.73 m²。6个月时受者GFR的独立预测因素为供体Cockcroft-Gault GFR(肌酐清除率;β0.16;可信区间0.13至0.29;P < 0.0001)、激素抵抗性排斥反应(β - 6.07;可信区间 - 12.05至 - 0.09;P = 0.006)和移植肾功能延迟恢复(DGF)(β - 10.0;可信区间 - 19.52至 - 0.49;P = 0.039)。LDK移植受者的肾功能由供体GFR、激素抵抗性排斥反应发作次数和DGF预测。重要的是,供体Cockcroft-Gault GFR是预测受者肾功能的最重要特征。

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