Department of Renal Transplantation, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
Chin Med J (Engl). 2011 Apr;124(8):1213-6.
For the renal transplant recipients, anemia is one of the common complications and becomes a major medical issue before transplantation. Haemoglobin (Hb) is used as a prognostic indicator, although the optimal pre-transplantation Hb concentration associated with positive prognosis is still controversial. The aim of this study was to detect the optimal Hb concentration on predicting the graft survival and function.
A retrospective cohort study was conducted by reviewing the medical records of the patients who received renal transplantations at our center from January 2004 to June 2008. Patients were divided into two groups: high Hb group (≥ 100 g/L, n = 79) and low Hb group (< 100 g/L, n = 63). There was no significant difference between the two groups regarding sex, age, blood type and tissue types. Renal function among the two groups was measured and compared. Panel reacting antigens (PRA) of all the recipients were negative. The effect of preoperative hemoglobin concentration on the postoperative renal function recovery in both groups was further analyzed.
A total of 14 acute rejection episodes occurred, including 5 patients in the high Hb group (7.9%) and 9 in the low Hb group (11.4%, P > 0.05). The serum creatinine level at one-year post-transplantation of the low Hb group was significantly higher than that of the high Hb group ((117.8 ± 36.3) µmol/L vs. (103.1 ± 35.5) µmol/L, P < 0.05). For one-year actuarial patient and graft survival, incidence of delayed graft function (DGF), serum creatinine concentrations at 1, 3, 6 months post-transplantation, the incidence of cytomegalovirus (CMV) infection, post-transplantation anemia (PTA) and post-transplantation diabetes mellitus (PTDM) of both groups, there were no statistically significant differences.
Pre-transplantation Hb concentration has significant effect on one-year creatinine concentration, but can not significantly affect acute rejection episodes, DGF, PTA, CMV infection and PTDM.
对于肾移植受者来说，贫血是常见的并发症之一，在移植前成为一个主要的医学问题。血红蛋白（Hb）被用作预后指标，尽管与积极预后相关的最佳移植前 Hb 浓度仍存在争议。本研究的目的是检测预测移植物存活和功能的最佳 Hb 浓度。
通过回顾 2004 年 1 月至 2008 年 6 月在我院接受肾移植的患者的病历，进行了一项回顾性队列研究。患者分为两组：高 Hb 组（≥100g/L，n=79）和低 Hb 组（<100g/L，n=63）。两组在性别、年龄、血型和组织类型方面无显著差异。比较两组的肾功能。所有受者的 panel 反应抗原（PRA）均为阴性。进一步分析了两组术前血红蛋白浓度对术后肾功能恢复的影响。
共发生 14 例急性排斥反应，其中高 Hb 组 5 例（7.9%），低 Hb 组 9 例（11.4%），差异无统计学意义（P>0.05）。低 Hb 组患者移植后 1 年时血清肌酐水平明显高于高 Hb 组[（117.8±36.3）µmol/L 比（103.1±35.5）µmol/L，P<0.05]。在 1 年的患者和移植物存活率、延迟移植物功能（DGF）发生率、移植后 1、3、6 个月的血清肌酐浓度、巨细胞病毒（CMV）感染、移植后贫血（PTA）和移植后糖尿病（PTDM）发生率方面，两组间无统计学差异。
移植前 Hb 浓度对 1 年时的肌酐浓度有显著影响，但不能显著影响急性排斥反应、DGF、PTA、CMV 感染和 PTDM。
