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死亡供体肾移植术后初期血清中促炎标志物浓度变化的决定因素。

Factors determining changes in concentrations of pro-inflammatory markers in blood serum in the initial period after kidney transplantation from dead donor.

作者信息

Caban Artur, Budziński Grzegorz, Oczkowicz Grzegorz, Suszka-Switek Aleksandra, Dec Renata, Cierpka Lech

机构信息

Department of General, Vascular and Transplant Surgery, Silesian Medical University, Katowice, Poland.

出版信息

Ann Transplant. 2009 Oct-Dec;14(4):10-3.

Abstract

BACKGROUND

The main aim of this paper is to determine scope of changes in concentration of selected pro-inflammatory factors in blood serum in the initial period after the kidney transplantation from the brain death donor and attempt of establishing which of them are connected with delayed function of the organ, initial condition of both the donor and the recipient.

MATERIAL/METHODS: The prospective examination carried out in group of 20 patients that underwent kidney transplantation from 10 donors diagnosed brain death. Blood samples were drawn before the transplantation procedure, 4 hours after procedure and in 4(th) day after the procedure. The blood serum analysis included: interleukin-6 (IL-6), tumor necrosis factor-alpha, interleukin-1beta (IL-1b) and C-reactive protein (CRP).

RESULTS

In perioperative period the dynamic changes of all observed markers were noticed, especially in 4 th hour after the transplantation procedure. Generally, apart from TNFalpha, their concentration in blood serum was raising (the most significantly for IL-6) and then in 4(th) day reached the level equal to or lower than before transplantation.

CONCLUSIONS

The delayed graft function is accompanied by high CRP level in donors before grafting and sustaining rise of IL-1b content in blood serum in 4(th) day after the transplantation procedure. The IL-6 content in this period revealed similar tendency in recipients' pairs that have been given the kidney from one donor, reflecting the condition of an organ that has been transplanted.

摘要

背景

本文的主要目的是确定脑死亡供体肾移植术后初期血清中所选促炎因子浓度的变化范围,并试图确定其中哪些与器官功能延迟、供体和受体的初始状况有关。

材料/方法:对20例接受10例脑死亡供体肾移植的患者进行前瞻性检查。在移植手术前、手术后4小时和手术后第4天采集血样。血清分析包括:白细胞介素-6(IL-6)、肿瘤坏死因子-α、白细胞介素-1β(IL-1b)和C反应蛋白(CRP)。

结果

围手术期观察到所有标志物的动态变化,尤其是在移植手术后第4小时。一般来说,除了TNFα,它们在血清中的浓度升高(IL-6最为显著),然后在第4天达到等于或低于移植前的水平。

结论

移植肾功能延迟与移植前供体中CRP水平升高以及移植手术后第4天血清中IL-1b含量持续升高有关。在此期间,来自同一供体的受体对中IL-6含量呈现相似趋势,反映了移植器官的状况。

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