Zavacka M, Frankovicova M, Pobehova J, Zavacky P
Bratisl Lek Listy. 2018;119(7):416-420. doi: 10.4149/BLL_2018_075.
The aim of this study was to analyze the benefit of the patients after renal transplantation with an assessment of the significance of different surgical techniques in patients with renal transplantation (not only from the dead but also the living donors) with multiple arteries. 457 patients with end stage renal disease (ESRD) in the treatment using the extracorporeal elimination method (haemodialysis, or peritoneal dialysis), who in the period from 2005 to 2015 had a kidney transplant were included in our retrospective study. Our results confirm that the patients after kidney transplantation with cold ischemia time more than 12 hours have 2.5 times higher risk of delayed onset, possibly failure of graft function compared to those with cold ischemia time less than 12 hours. This confirms our experience that the best option for the patient to achieve a stable graft function with long-term perspective is cold ischemia time of less than 12 hours and the realisation of renal artery angioplasty. In this case, the risk of delayed onset of transplanted kidney function or graft failure decreases 4.5 times compared to the respondents with cold ischemia time more than 12 hours without carrying out arterial angioplasty (Tab. 1, Fig. 4, Ref. 16).
本研究旨在分析肾移植患者的获益情况,并评估不同手术技术在多支动脉肾移植患者(包括尸体供肾和活体供肾)中的意义。我们的回顾性研究纳入了457例采用体外清除方法(血液透析或腹膜透析)治疗的终末期肾病(ESRD)患者,这些患者在2005年至2015年期间接受了肾移植。我们的结果证实,冷缺血时间超过12小时的肾移植患者发生延迟发病的风险是冷缺血时间少于12小时患者的2.5倍,移植肾功能可能衰竭。这证实了我们的经验,即从长期来看,实现稳定移植肾功能的最佳选择是冷缺血时间少于12小时并进行肾动脉血管成形术。在这种情况下,与冷缺血时间超过12小时且未进行动脉血管成形术的患者相比,移植肾功能延迟发病或移植失败的风险降低了4.5倍(表1,图4,参考文献16)。