Zukowski M, Kotfis K, Biernawska J, Zegan-Barańska M, Kaczmarczyk M, Ciechanowicz A, Brykczyński M, Ostrowski M, Nikodemski T, Bohatyrewicz R
Department of Anaesthesiology and Intensive Care, Pomeranian Medical University, Szczecin, Poland.
Transplant Proc. 2011 Oct;43(8):2914-6. doi: 10.1016/j.transproceed.2011.08.068.
We sought to determine the risk factors influencing the occurrence of early graft loss among kidney transplant recipients.
One hundred forty-six potential donors and 230 kidney recipients were included in the study. Prior to organ procurement we collected demographic data as well as hemodynamic data of mean arterial pressure, central venous pressure, pulmonary capillary wedge pressure, systemic vascular resistance index acquired by means of a thermodilution method. The recipient data included age, gender, prior hemodialysis period, panel-reactive antibodies, cold ischemia time, renal insufficiency cause, and donor-recipient gender mismatch. We assessed the influence of the data on graft loss at 30 days after renal transplantation. To confirm the relationships, we performed statistical analyses using chi-square, Fisher exact, and V. Cramer tests.
There were no significant relationships between the analyzed parameters and early graft loss in the study group except for gender mismatch. The 71 female recipients of male kidneys showed the lowest graft survival: donor/recipient male/female 89%; donor/recipient female/male 97%; no mismatch 97% (P=.01).
Female recipients of male kidneys may experience a greater risk of early graft loss compared with all other gender combinations.
我们试图确定影响肾移植受者早期移植肾丢失发生的危险因素。
146名潜在供者和230名肾移植受者纳入本研究。在器官获取前，我们收集了人口统计学数据以及通过热稀释法获得的平均动脉压、中心静脉压、肺毛细血管楔压、全身血管阻力指数等血流动力学数据。受者数据包括年龄、性别、既往血液透析时间、群体反应性抗体、冷缺血时间、肾功能不全病因以及供受者性别不匹配情况。我们评估了这些数据对肾移植术后30天移植肾丢失的影响。为确认这些关系，我们使用卡方检验、Fisher精确检验和V. Cramer检验进行统计分析。
除性别不匹配外，研究组中分析的参数与早期移植肾丢失之间无显著关系。71名接受男性供肾的女性受者移植肾存活率最低：供者/受者为男性/女性时为89%；供者/受者为女性/男性时为97%；无性别不匹配时为97%（P = 0.01）。
与所有其他性别组合相比，接受男性供肾的女性受者早期移植肾丢失风险可能更高。
