肾移植后移植肾功能恢复延迟对远期移植肾功能的影响

Long term renal function of Donation after citizen＇s deceased transplantation

目的探讨公民逝世后器官捐献（DCD）供者供肾移植术后远期移植肾的功能状况。方法分析2016年7月前接受DCD供肾移植，且术后发生移植肾功能恢复延迟（DGF）的38例受者作为DGF组，随机选取同期实施肾移植术后正常恢复的肾功能稳定（IGF）组受者80例，分析两组受者术后3年内移植肾相关指标血肌酐、估算肾小球滤过率（eGFR）及尿蛋白的情况。结果术后1、2、3年两组受者间血肌酐的差异均无统计学意义（P〉0．05）；两术后1年组和两术后2年组受者问eGFR的差异均无统计学意义（P〉幔05），两术后3年组间eGFR的差异有统计学意义（P=0．042）；术后2年和3年，DGF3年组的尿蛋白阳性率较IGF3年组均显著提高，差异均有统计学意义（P=0．028，P=0．037）。结论DCD供肾移植术后发生DGF对于远期移植肾功能有显著影响，主要表现在术后2和3年eGFR降低和尿蛋白阳性率升高。

Objective To study long term renal function of Donation after citizen＇s deceased transplantation. Methods We compared the data of 38 subjects who got Delayed Graft Function（IX-F） with 80 Immediate Graft Function（IGF） subjects underwent DCD transplantation in our hospital before June 2016. Evaluated the renal function by detecting the serum creatinine （sCr）, the estimating glomerular filtration rate （eGFR） calculated with MDRD formula and urine protein at the 1,2,3 year post transplantation. Results Analyzed the serum eGFR of two groups, there was no significant differences at 1 and 2 year post transplantation, sCr of two groups showed no significant differences at 3 year （P = 0. 053）post transplantation, eGFR of two groups showed significant differences at 3 year （P= 0. 042）post transplantation and positive incidence of urine protein showed significant differences at 2 year （P = 0. 028）and 3 year （P = 0. 037）post transplantation. Conclusion DGFoccuring after DCD transplantation had an effect on long term renal function,, mainly on reducing of eGFR and increasing of urine protein positive rate 2 or 3 years after transplant.