Zukowski M, Bohatyrewicz R, Krawczyk A A
Clinic of Anaesthesiology and Intensive Care, Pomeranian Medical University, Szczecin, Poland.
Transplant Proc. 2007 Nov;39(9):2704-6. doi: 10.1016/j.transproceed.2007.09.016.
Efficient urine production after kidney transplantation is often evidence of good graft function. If severe organ injury occurs, we have oliguria or anuria and the patient requires postoperative hemodialysis. In most cases, graft function recovers after a few hemodialysis treatments-delayed graft function (DGF). Therefore, recognition of factors influencing the onset of DGF is crucial. We examined the state of the circulatory system by a thermodilution method in 101 organ donors, taking into account mean arterial pressure (MAP), central venous pressure (CVP), pulmonary capillary wedge pressure (PCWP), systemic vascular resistance index. We also examined 232 kidney recipients, based on age, gender, panel-reactive antibody, cold ischemia time, and reason for renal insufficiency. We defined DGF as at least one hemodialysis after kidney transplantation. In logistic regression analysis, we showed that donor MAP, CVP, and PCWP of the substantially influenced the occurrence of DGF among kidney transplant recipients. Maintaining an adequate MAP and a sufficient volume in the donor circulatory system substantially decreased the occurrence of DGF after kidney transplantation.
肾移植后高效的尿液生成通常是移植物功能良好的证据。如果发生严重的器官损伤，我们会出现少尿或无尿，患者需要术后血液透析。在大多数情况下，经过几次血液透析治疗后移植物功能会恢复——即移植肾功能延迟恢复（DGF）。因此，识别影响DGF发生的因素至关重要。我们采用热稀释法对101名器官捐献者的循环系统状态进行了检查，同时考虑了平均动脉压（MAP）、中心静脉压（CVP）、肺毛细血管楔压（PCWP）、全身血管阻力指数。我们还根据年龄、性别、群体反应性抗体、冷缺血时间和肾功能不全的原因对232名肾移植受者进行了检查。我们将DGF定义为肾移植后至少进行一次血液透析。在逻辑回归分析中，我们发现捐献者的MAP、CVP和PCWP对肾移植受者中DGF的发生有显著影响。在供体循环系统中维持足够的MAP和充足的血容量可显著降低肾移植后DGF的发生率。
