摘要
目的探讨亲属活体供肾移植术后近期及中长期供、受者的安全性。方法对106名亲属活体供肾者及其受者进行随访。随访日分别为肾移植后2个月至7年，其中32名供者随访时处于术后3个月内，44名处于术后3个月至1年，30名处于术后1年以上（其中术后1～3年者14名，3～5年者11名，5年以上者5名）。以GFR作为评估供、受者肾功能的主要指标，比较供、受者手术前后的肾功能以及血压和尿蛋白。GFR的计算采用同位素发射计算机辅助断层显像法（GFRECT法）、24h尿肌酐（Cr）清除率法（GFR-24h Urine法）及Cockcroft-Gault公式法（GFR-Cr法）。结果取肾前106名供者的GFR-ECT和GFR—Cr分别为（1．51±0．13）和（1．99±0．42）ml／s，GFR-ECT是GFR—Cr的75．8％；术后第5天，供者的GFR—Cr为（1．40±0．33）ml／s，为术前的70．5％；术后3个月内、3个月至1年和1年以上者的GFR-Cr分别为（1．47±0．28）、（1．36±0．24）和（1．37±0．23）ml／s，分别为取肾术前的73．7％、68．0％和68．6％；术后1～3年者、3～5年者及5年以上者的GFR-Cr与超过1年者整体的GFR-Cr比较，差异无统计学意义（P〉O．05）。4名供者术后尿蛋白为±，均为术后超过1年者；4名供者血压升高。术后3个月、1年及1年以上，受者的GFR-Cr分别为（1．09±0．26）、（1．20±0．31）和（1．07±0．29）ml／s。结论术后近期供者的GFR会下降，并小幅波动，术后中长期其GFR接近术前70％的水平，并趋于稳定。亲属活体供肾移植术后供、受者具有良好的安全性。
Objective To investigate the safety of Chinese donor and recipient in the short term and median-long term after living-related kidney transplantation. Methods 106 pairs of donors and recipients subject to living-related kidney transplantation were randomly selected. They were followed up from 2 months to 7 years after transplantation. Thirty-two pairs were in the duration of 3 months post-transplantation, 44 pairs from 3 months to 1 year, and 30 pairs beyond 1 year （14 pairs from 1 3 years, 11 pairs from 3-5 years, and 5 pairs beyond 5 years）. GFR was used to evaluate kidney function. The kidney function, blood pressure and proteinuria were compared before and post transplantation in the donors and recipients. Results Before donation in 106 donors, GFR-ECT was 1.51±0. 13, 75.8% of GFRCr as 1.99±0. 42 ml/s; 5 days after operation, GFR-Cr in donors was 1.40±0. 33 ml/s, a decreased level to 70. 5% GFR-Cr was 1.47±0. 28, 1.36±0. 24 and 1.37±0. 23 ml/s at 3rd month, 3rd month-first year, and beyond 1 year, a decreased level to 73. 70%, 68.0% and 68.6%, respectively. No significant difference in GFR-Cr was found among the donors 1- 3 years, 3-5 years and beyond 5 years after operation as compared with the whole level in the donors beyond 1 year （P〉0. 05）. Four donors, all beyond 1 year, were found having proteinuria trace, and 4 donors had a mild increase in blood pressure. The GFR-Cr in recipients was 1.09±0. 26, 1.20±0.31, and 1.07±0.29 ml/s at the 3rd month, first year, beyond 1 year after operation, respectively. Conclusion The GFR in donors is decreased mildly and fluctuated in the short term after donation, then stabilize at a level of 70%. The donors and recipients have a good safety in the living-related kidney transplantation.
出处
《中华器官移植杂志》
CAS
CSCD
北大核心
2009年第10期616-619,共4页
Chinese Journal of Organ Transplantation
关键词
肾移植
活体供者
手术后期间
肾功能试验
Kidney transplantation
Living donors
Postoperative period
Kidney function tests
