影响围手术期活体肾移植肾功能恢复的供者相关因素分析

Risk factors of donor for a recovery of graft function during perioperative period in living relative donor kidney transplantation

目的探讨活体肾移植中围手术期移植肾功能恢复的供者相关影响因素。方法回顾性分析2010年1月至2018年12月于吉林大学第一医院进行的327对活体肾移植供、受者的临床数据资料,比较供者相关因素对围手术期移植肾功能恢复的影响。结果供者行后腹腔镜左侧供肾切取术263例,右侧供肾切取术64例,两组在手术时间、术中失血量、热缺血时间、术后淋巴漏百分比及围手术期移植肾功能恢复等方面差异没有统计学意义(P>0.05),但左侧供肾切取组的手术时间短于右侧供肾切取组,差异有统计学意义(P=0.008)。供肾动脉血管变异对围手术期移植肾功能恢复没有影响(P>0.05),供者年龄、供肾肾小球滤过率(GFR)及供、受者体重指数(BMI)差值与围手术期移植肾功能恢复具有相关性(P值分别为0.006、0.002及<0.001)。多因素分析后,供肾GFR及供、受者BMI差值与围手术期移植肾功能恢复具有相关性(P值分别为0.007及<0.001)。结论供者GFR及供、受者BMI差值是围手术期移植肾功能恢复的独立危险因素。

Objective To explore the risk factors of donor for a recovery of graft function during perioperative period of living relative donor kidney transplantation.Methods Retrospective reviews were performed for the relevant clinical data of 327 donors and recipients of living related kidney transplantation from January 2010 to December 2018.The donor risk factors were compared.Results No significant differences existed in operative duration,intraoperative blood loss,warm ischemic time,postoperative lymph leakage percentage or perioperative graft function between different donor nephrectomic groups(P>0.05).However,operative duration of left donor nephrectomy was shorter than that of right donor nephrectomy and the difference was statistically significant(P=0.008).Vascular anatomic abnormality had no effect on perioperative graft function(P>0.05).And donor age,donor glomerular filtration rate(GFR)and difference between donor body mass index(BMI)and recipient BMI had correlations with perioperative graft function(P=0.006,0.002,<0.001).After multivariate analysis,donor GFR and difference between donor BMI and recipient BMI were correlated with perioperative graft function(P=0.007,<0.001).Conclusions Donor GFR and difference between donor BMI and recipient BMI are independent risk factors for perioperative graft function.