Król R, Chudek J, Kolonko A, Ziaja J, Pawlicki J, Wiecek A, Cierpka L
Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Poland.
Transplant Proc. 2011 Oct;43(8):2926-9. doi: 10.1016/j.transproceed.2011.08.019.
Resistive index (RI) measured by Doppler sonography in the early period after kidney transplantation is a well-known predictor of kidney transplant outcome. The purpose of this study was to analyze the impact of RI values calculated intraoperatively in renal allograft artery using transit time flowmetry (TTF) on both early and long-term kidney graft function.
TTF was performed on 72 patients who received kidney grafts fed by a single artery. TTF was performed before wound closure. We excluded patients with an early acute rejection (n=8), an early graft loss (n=2), or primary graft nonfunction (n=1). Recipients were divided into RI tertile groups. The initial kidney graft function was defined as immediate (IGF), slow or delayed. Kidney graft estimated glomerular filtration rate (eGFR) was analyzed upon long-term follow-up.
Patients with a low RI (<0.57) showed the highest incidence of immediate graft function (65% versus 5.3%), whereas the high RI group (>0.70). Show the most frequent rate of delayed graft function (52.6% versus 15%). Recipients with low RI values displayed significantly better eGFR (by at least 12 mL/min/1.73 m2) than those with medium or high RI values at all analyzed times; subjects with medium or high RI showed similar eGFR at 48-months.
An high RI value measured intraoperatively was a valuable predictor of inferior early and long-term kidney graft function.
肾移植术后早期通过多普勒超声测量的阻力指数（RI）是肾移植结果的一个众所周知的预测指标。本研究的目的是分析术中使用渡越时间血流仪（TTF）计算的肾移植动脉RI值对早期和长期肾移植功能的影响。
对72例接受单动脉供血肾移植的患者进行TTF检查。TTF在伤口缝合前进行。我们排除了早期急性排斥反应患者（n = 8）、早期移植肾丢失患者（n = 2）或原发性移植肾功能不全患者（n = 1）。受者被分为RI三分位数组。初始肾移植功能定义为即刻（IGF）、缓慢或延迟。在长期随访中分析肾移植估计肾小球滤过率（eGFR）。
RI低（<0.57）的患者即刻移植肾功能发生率最高（65%对5.3%），而RI高（>0.70）的组延迟移植肾功能发生率最高（52.6%对15%）。RI值低的受者在所有分析时间的eGFR均显著优于RI值中等或高的受者（至少高12 mL/min/1.73 m2）；RI值中等或高的受试者在48个月时eGFR相似。
术中测量的高RI值是早期和长期肾移植功能较差的一个有价值的预测指标。
