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死体供肾移植术后初始肾功能的临床意义

Clinical implications of initial renal function after deceased donor transplant.

作者信息

Guimarães-Souza N, Dalboni M A, Canziani M E, Tedesco-Silva H, Batista M C, Sesso R, Câmara N O, Medina-Pestana J O, Pacheco-Silva A, Cendoroglo M

机构信息

Federal University of São Paulo, São Paulo, Brazil.

出版信息

Transplant Proc. 2010 May;42(4):1084-9. doi: 10.1016/j.transproceed.2010.03.067.

DOI:10.1016/j.transproceed.2010.03.067
PMID:20534229
Abstract

The aim of this study was to investigate whether slow graft function (SGF) after transplantation of deceased-donor kidneys affected the prevalence of anemia or the glomerular filtration rate (GFR). We retrospectively evaluated the records of 534 kidney transplant patients who were classified based on their initial renal function, namely, immediate graft function (IGF), slow graft function (SGF), or delayed graft function (DGF). Among the 534 kidney transplant patients studied, the occurrences of each condition were IGF 104, SGF 133, and DGF 297. Six months after transplantation, a greater percentage of DGF patients were anemic compared with the others (P = .028). However, at 12 months after transplantation, SGF patients showed more anemia than the IGF group. DGF and SGF patients displayed similar GFR values at 18 and 24 months after transplantation. However, IGF patients displayed higher GFRs, even when subjects who experienced acute rejection episodes were censored (P = .004). The incidence of acute rejection episodes was similar among SGF and DGF patients. Patients displaying SGF after deceased-donor transplantation showed a greater tendency to be anemic than those displaying IGF. This study also suggested that SGF patients were at risk for acute rejection episodes and/or significantly reduced kidney function as measured by GFR.

摘要

本研究的目的是调查已故供体肾移植后的缓慢移植肾功能（SGF）是否会影响贫血患病率或肾小球滤过率（GFR）。我们回顾性评估了534例肾移植患者的记录，这些患者根据其初始肾功能进行分类，即即刻移植肾功能（IGF）、缓慢移植肾功能（SGF）或延迟移植肾功能（DGF）。在研究的534例肾移植患者中，每种情况的发生率分别为IGF 104例、SGF 133例和DGF 297例。移植后6个月，与其他患者相比，DGF患者贫血的比例更高（P = 0.028）。然而，移植后12个月，SGF患者的贫血情况比IGF组更严重。移植后18个月和24个月，DGF和SGF患者的GFR值相似。然而，即使剔除经历急性排斥反应的受试者，IGF患者的GFR仍更高（P = 0.004）。SGF和DGF患者急性排斥反应的发生率相似。已故供体移植后出现SGF的患者比出现IGF的患者更容易贫血。本研究还表明，SGF患者有发生急性排斥反应和/或GFR测量显示肾功能显著降低的风险。

相似文献

1
Clinical implications of initial renal function after deceased donor transplant.死体供肾移植术后初始肾功能的临床意义
Transplant Proc. 2010 May;42(4):1084-9. doi: 10.1016/j.transproceed.2010.03.067.
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Recovery of graft function early posttransplant determines long-term graft survival in deceased donor renal transplants.移植后早期移植物功能的恢复决定了尸体供肾移植中长期的移植物存活情况。
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Delayed graft function in renal transplant recipients: risk factors and impact on 1-year graft function: a single center analysis.肾移植受者的移植肾功能延迟：危险因素及其对1年移植肾功能的影响：一项单中心分析
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引用本文的文献

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The Association Between Early Graft Function, Donor Type and Long-Term Kidney Transplant Outcomes.早期移植肾功能、供体类型与肾移植长期预后之间的关联
Transpl Int. 2025 May 16;38:14197. doi: 10.3389/ti.2025.14197. eCollection 2025.
2
A systematic review and meta-analysis of factors contributing to post-kidney transplant anemia and the effect of erythropoietin-stimulating agents.一项系统评价和荟萃分析，探讨导致肾移植后贫血的因素以及促红细胞生成素刺激剂的影响。
Syst Rev. 2024 Nov 12;13(1):278. doi: 10.1186/s13643-024-02709-8.
3
P-NGAL Day 1 predicts early but not one year graft function following deceased donor kidney transplantation - The CONTEXT study.
P-NGAL 第 1 天预测供体肾移植后早期但非 1 年的移植物功能 - CONTEXT 研究。
PLoS One. 2019 Feb 28;14(2):e0212676. doi: 10.1371/journal.pone.0212676. eCollection 2019.
4
Remote ischaemic conditioning on recipients of deceased renal transplants, effect on immediate and extended kidney graft function: a multicentre, randomised controlled trial protocol (CONTEXT).已故肾移植受者的远程缺血预处理对即刻和长期肾移植功能的影响：一项多中心随机对照试验方案（CONTEXT）
BMJ Open. 2015 Aug 20;5(8):e007941. doi: 10.1136/bmjopen-2015-007941.