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来自患有横纹肌溶解症和急性肾衰竭供体的肾移植。

Kidney transplantation from donors with rhabdomyolysis and acute renal failure.

作者信息

Chen Chuan-Bao, Zheng Yi-Tao, Zhou Jian, Han Ming, Wang Xiao-Ping, Yuan Xiao-Peng, Wang Chang-Xi, He Xiao-Shun

机构信息

Organ Transplant Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

出版信息

Clin Transplant. 2017 Aug;31(8). doi: 10.1111/ctr.13021. Epub 2017 Jun 22.

Abstract

Rhabdomyolysis in deceased donors usually causes acute renal failure (ARF), which may be considered a contraindication for kidney transplantation. From January 2012 to December 2016, 30 kidneys from 15 deceased donors with severe rhabdomyolysis and ARF were accepted for transplantation at our center. The peak serum creatinine (SCr) kinase, myoglobin, and SCr of the these donors were 15 569±8597 U/L, 37 092±42 100 μg/L, and 422±167 μmol/L, respectively. Two donors received continuous renal replacement therapy due to anuria. Six kidneys exhibited a discolored appearance (from brown to glossy black) due to myoglobin casts. The kidney transplant results from the donors with rhabdomyolysis donors were compared with those of 90 renal grafts from standard criteria donors (SCD). The estimated glomerular filtration rate at 2 years was similar between kidney transplants from donors with rhabdomyolysis and SCD (70.3±14.6 mL/min/1.73 m vs 72.3±15.1 mL/min/1.73 m ). We conclude that excellent graft function can be achieved from kidneys donors with ARF caused by rhabdomyolysis.

摘要

已故供体的横纹肌溶解症通常会导致急性肾衰竭(ARF),这可能被视为肾移植的禁忌症。2012年1月至2016年12月,我们中心接受了15名患有严重横纹肌溶解症和ARF的已故供体的30个肾脏进行移植。这些供体的血清肌酐激酶、肌红蛋白和血清肌酐峰值分别为15569±8597U/L、37092±42100μg/L和422±167μmol/L。两名供体因无尿接受了持续肾脏替代治疗。6个肾脏因肌红蛋白管型而出现变色(从棕色到亮黑色)。将横纹肌溶解症供体的肾移植结果与90个来自标准标准供体(SCD)的肾移植结果进行了比较。横纹肌溶解症供体的肾移植与SCD肾移植在2年时的估计肾小球滤过率相似(70.3±14.6mL/min/1.73m²对72.3±15.1mL/min/1.73m²)。我们得出结论,由横纹肌溶解症引起的ARF供体的肾脏可以实现出色的移植功能。

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