供/受者体表面积比对公民器官捐献肾移植术后受者早期肾功能康复的影响

Effect of donor/recipient body surface area ratio on the rehabilitation of renal function of potential recipient after renal transplantation from donation after citizen death

目的:探讨供/受者体表面积(BSA)比对公民器官捐献(DCD)肾移植术后受者早期肾功能康复的影响。方法:回顾性分析2011年3月至2016年3月在湖南省益阳市中心医院治疗的101例DCD肾移植术受者的临床资料,根据供/受者BSA比值分为3组:BSA比值≤0.8为A组(n=26),0.8<BSA比值<1.2为B组(n=55),BSA比值≥1.2为C组(n=20)。随访统计术后1周、1个月、3个月、6个月、12个月受者的肾功能康复情况。结果:术后1周至12个月内各时间点,C组血清肌酐(Scr)均显著低于A组,而肾小球滤过率(eGFR)显著高于A组(均P<0.05);术后6个月、12个月,C组的Scr显著低于B组,而eGFR显著高于B组(均P<0.05);B组、C组术后早期肾功能康复率显著高于A组(P<0.05);术后12个月内,3组急性排斥反应(AR)发生率比较,差异无统计学意义(P>0.05),而B组、C组的移植肾功能延迟恢复(DGF)发生率显著低于A组(P<0.05),但B组、C组间比较,差异无统计学意义(P>0.05)。结论:供/受者BSA比值可影响DCD肾移植术后受者早期肾功能康复,BSA比值>0.8更有利于受者术后肾功能康复。

Objective： To investigate the effect of donor/recipient body surface area （BSA） ratio on the rehabilitation of renal function of potential recipient after renal transplantation from donation after citizen death （DCD）. Methods： The clinical data of 101 potential recipients after renal transplantation from DCD were retrospectively analyzed, and divided into three groups according to the donor/recipient BSA ratio： group A with BSA ratio≤0.8 （n=26）, group Bwith BSAratio ranged from 0.8 to 1.2 （n= 55） and group C with BSA ratio≥1. 2 （n=20）. The serum level of Scr and graft eGFR at 1 week, 3, 6 and 12 months post-operation were recorded respectively. Results.. At each time point after renal transplantation, the serum level of Scr in group C was significantly lower than that in group A, while the graft eGFR was significantly higher （P〈0.05）. At 6 and 12 months after renal transplantation, the serum level of Scr in group C was signifi cantly lower than that in group B, while the graft eGFR was significantly higher （P〈0.05）. The post operation early renal function recovery rate in group B and C were significantly higher than that in group A （P 〈0.05）. At 12 months after operation, the acute rejection （AR） rate in three groups showed no significant deference （P〉0. 05）, but the graft delay recovery （DGF） rate in group B and C was significantly lower than that in group A （P〈0.05）, but there was no significant difference between group B and group C （P〉0.05）. Conclusion. The donor/recipient BSA ratio could affect the rehabilitation of renal function of potential recipient after renal transplantation from DCD. BSA ratio〉0.8 could achieve a better postoperative renal transplantation of potential recipient.