Lifeport灌注液中生物标志物与尸体供体肾移植术后移植肾功能延迟恢复的相关性分析

Study on the relationship between biomarkers in Lifeport perfusion solution and delayed graft function after deceased donor renal transplantation

目的分析Lifeport灌注液中生物标志物与尸体供体肾移植术后移植肾功能延迟恢复(delayed graft function,DGF)的相关性,为临床决策提供理论依据。方法回顾性分析2019年6月1日—2019年8月31日期间西安交通大学第一附属医院43例DD肾脏应用Lifeport进行灌注维护的参数指标、灌注液生物标志物及实施肾移植的临床资料,对DGF的发生率及肾功能恢复时间等情况进行总结和分析。结果本研究的DGF发生率为18.6%(8/43),肾功能恢复时间为(11.7±10.6)d;DGF组肾功能恢复时间〔(30.8±22.7)d〕较NO-DGF组〔(6.8±7.0)d〕显著延长(P<0.001)。多因素logistic回归分析显示终末阻力(OR=1.879,95%CI=1.145~3.56)和灌注液标志物谷胱甘肽S-转移酶(glutathione S-transferase,GST)(OR=1.62,95%CI=1.23~2.46)是DGF的独立危险因素。比较GST联合终末阻力预测DGF的ROC曲线下面积(area under curve,AUC)与单独应用终末阻力预测DGF的AUC,预测准确性相较于单独应用终末阻力显著提高(P=0.023)。结论灌注参数(终末阻力)联合灌注液生物标志物(GST)可提高预测DGF的能力。

Objective To analyze the correlation between biomarkers in Lifeport perfusion solution and delayed graft function(DGF)after deceased donor(DD)renal transplantation.Methods The parameters of Lifeport perfusion maintenance,biomarkers of perfusion fluid and clinical data of 43 renal transplantation recipients during the period from 1 June 2019 to 31 August 2019 at the first affiliated Hospital of Xi'an Jiaotong University were prospective collected.The incidence of DGF and the recovery time of renal function were summarized and analyzed by statistical methods.Results In this study,the incidence of DGF was 18.6%,and the recovery time of renal function was(11.7±10.6)d.The recovery time of renal function in DGF group〔(30.8±22.7)d〕was significantly longer than that in NO-DGF group〔(6.8±7.0)d〕(P<0.001).Multivariate logistic regression analysis showed that terminal resistance(OR=1.879,95%,CI=1.145~3.56)and perfusion marker glutathione S-transferase(GST)(OR=1.62,95%CI=1.23~2.46)were independent risk factors for DGF.Comparing with ROC area under curve(AUC),the accuracy of prediction was significantly higher when GST combined with terminal resistance prediction than that of terminal resistance prediction alone(P=0.023).Conclusion Perfusion parameters(terminal resistance)combined with the biomarker of perfusion fluid(GST)can improve the ability of predicting DGF.