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影响已故供体肾移植结局的急性肾损伤供体因素。

Factors of Acute Kidney Injury Donors Affecting Outcomes of Kidney Transplantation From Deceased Donors.

作者信息

Kwon Jin Ah, Park Hojong, Park Sang Jun, Cho Hong Rae, Noh Minsu, Kwon Eun Kyoung, Kim Gi Ppeum, Park Kyung Sun, Park Jongha, Lee Jong Soo

机构信息

Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.

Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.

出版信息

Transplant Proc. 2019 Oct;51(8):2575-2581. doi: 10.1016/j.transproceed.2019.03.068. Epub 2019 Aug 29.

Abstract

BACKGROUND

This study aimed to investigate the outcomes of kidney transplantation (KT) from deceased acute kidney injury (AKI) donors and analyzed the factors affecting these outcomes.

METHODS

All patients who underwent KT from deceased donors at our institution from 1998 to 2016 were retrospectively reviewed. Recipients were divided into the AKI and non-AKI donor groups. We analyzed delayed graft function (DGF), serum creatinine levels at 1 month and 1 year after KT, cold ischemia time, donors' initial and terminal serum creatinine levels, Kidney Donor Profile Index, and patient and graft survival in each group.

RESULTS

Of 181 recipients, 30 received kidneys from 21 AKI donors, whereas the remaining 151 received kidneys from donors without AKI. DGF more frequently developed in the AKI donor group than in the non-AKI donor group (40% vs 7.28%; P = .001). Allograft functions at 1 month and 1 year after KT did not differ between the AKI and non-AKI donor groups (1 month: P = .469; 1 year: P = .691). Factors affecting DGF were recipient weight and donor AKI. Recipient factors affecting graft function at 1 year were recipient height, length of hospital stay, serum creatinine levels at 1 month and 6 months, and biopsy-proven acute rejection. Older donor age was the only donor factor that affected graft function at 1 year.

CONCLUSION

KT from deceased AKI donors showed a higher DGF rate but favorable patient and graft survival and graft functions. Donor AKI and recipient weight affected DGF, and only older donor age affected graft function at 1 year.

摘要

背景

本研究旨在调查来自已故急性肾损伤(AKI)供体的肾移植(KT)结果,并分析影响这些结果的因素。

方法

对1998年至2016年在本机构接受已故供体KT的所有患者进行回顾性研究。将受者分为AKI供体组和非AKI供体组。我们分析了移植肾功能延迟恢复(DGF)、KT后1个月和1年时的血清肌酐水平、冷缺血时间、供体初始和终末血清肌酐水平、肾脏供体特征指数以及每组患者和移植物的存活率。

结果

181例受者中,30例接受了来自21例AKI供体的肾脏,其余151例接受了来自无AKI供体的肾脏。AKI供体组比非AKI供体组更频繁地发生DGF(40%对7.28%;P = 0.001)。AKI供体组和非AKI供体组在KT后1个月和1年时的移植肾功能无差异(1个月:P = 0.469;1年:P = 0.691)。影响DGF的因素是受者体重和供体AKI。影响1年时移植肾功能的受者因素是受者身高、住院时间、1个月和6个月时的血清肌酐水平以及活检证实的急性排斥反应。供体年龄较大是影响1年时移植肾功能的唯一供体因素。

结论

来自已故AKI供体的KT显示出较高的DGF发生率,但患者和移植物存活率及移植肾功能良好。供体AKI和受者体重影响DGF,且仅供体年龄较大影响1年时的移植肾功能。

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