Ozdemir F N, Ibis A, Altunoglu A, Usluogullari A, Arat Z, Haberal M
Department of Nephrology, Baskent University Hospital, Ankara, Turkey.
Transplant Proc. 2007 May;39(4):842-5. doi: 10.1016/j.transproceed.2007.03.026.
Delayed graft function (DGF) is associated with decreased long-term renal allograft survival, however, the entire mechanism of action of DGF has not yet been established. The goal of this study was to determine possible risk factors for DGF in young living-related renal allograft recipients. We retrospectively analyzed the outcome of 142 renal transplant recipients (115 men and 27 women; mean age, 29.7 +/- 9.43 years; 114 living-related donors and 28 cadaveric donors). Data recorded for each patient and donor included gender, age at transplantation, duration of pretransplantation dialysis (recipients only), body mass index, number of human leucocyte antigen mismatches, panel-reactive antibodies, donor creatinine clearance, body weight, systolic and diastolic blood pressure levels, lipid profile, and biochemical parameters. Having obtained the transplant from a cadaveric donor (P<.000, odds ratio [OR]=17.556, confidence interval [CI]=5.961-51.743) and a pretransplantation systolic blood pressure level in the recipient of <120 mm Hg (P<.021, OR=3.600, CI=1.214-10.672) were possible risk factors for DGF. When only living-related recipients were considered, the systolic blood pressure level was significantly associated with DGF. We concluded that a pretransplantation systolic blood pressure level <120 mm Hg is a risk factor for DGF and that preoperative blood pressure control and intervention may help to decrease the risk of DGF.
移植肾功能延迟(DGF)与肾移植长期存活降低相关,然而,DGF的完整作用机制尚未明确。本研究的目的是确定年轻的活体亲属肾移植受者发生DGF的可能危险因素。我们回顾性分析了142例肾移植受者的结局(115例男性和27例女性;平均年龄29.7±9.43岁;114例活体亲属供者和28例尸体供者)。记录的每位患者和供者的数据包括性别、移植时年龄、移植前透析时间(仅受者)、体重指数、人类白细胞抗原错配数、群体反应性抗体、供者肌酐清除率、体重、收缩压和舒张压水平、血脂谱及生化参数。接受尸体供者的移植(P<0.000,比值比[OR]=17.556,可信区间[CI]=5.961-51.743)以及受者移植前收缩压水平<120 mmHg(P<0.021,OR=3.600,CI=1.214-10.672)是DGF的可能危险因素。仅考虑活体亲属受者时,收缩压水平与DGF显著相关。我们得出结论,移植前收缩压水平<120 mmHg是DGF的一个危险因素,术前血压控制和干预可能有助于降低DGF的风险。