亲属活体供肾移植中供者肾功能的评估

背景:肾移植前正确有效地评价供者双侧肾脏功能,对于亲属活体肾移植供者及受者的安全十分重要。目的:探讨亲属活体供肾移植中供者肾功能评估的指标。方法:173例亲属活体肾移植供者年龄分成老年组(≥55岁)和中青年组(<55岁),两组供者移植前血清肌酐、总肾小球滤过率、欲保留肾总肾小球滤过率、内生肌酐清除率、血尿素氮反应肾功能指标差异无显著性意义,分析比较移植前后肾功能各指标的变化。结果与结论:与移植前比较,移植后10d供者血清肌酐、血尿素氮增高,内生肌酐清除率降低(P<0.01);移植后1个月留存肾脏总肾小球滤过率增加(P=0.0000),但与移植前供者双肾比较下降。提示总肾小球滤过率可作为活体亲属肾移植供者肾功能评估的主要指标,但是仍应结合血清肌酐、内生肌酐清除率等指标综合分析。

Evaluation of donor's renal function during living-related donor kidney transplantation

BACKGROUND:Proper effective evaluation of bilateral renal function before kidney transplantation is of importance for the safety of donors and recipients during living-related donor kidney transplantation. OBJECTIVE:To investigate the suitable indexes for evaluating living donor’s renal function in living-related donor kidney transplantation. METHODS:A total of 173 cases of living-related donor kidney transplantation were analyzed retrospectively. The donor grafts were divided into two groups:elderly group (≥55 years) and young- and middle-aged group (< 55 years). Before kidney transplantation, there was no significant difference in the indexes which reflect renal function, including serum creatinine, total glomerular filtration rate (GFR), remaining renal GFR, endogenous creatinine clearance rate, and blood urea nitrogen. Change in each index of renal function was compared before and after kidney transplantation. RESULTS AND CONCLUSION:Compared with before transplantation, serum creatinine and blood urea nitrogen levels were increased while renal total GFR was decreased at 10 days after transplantation (P < 0.01). At 1 month after transplantation, remaining renal total GFR was increased (P = 0.0000), but it increased compared with before transplantation. These findings suggest the renal total GFR can be used as a main index for evaluating the donor’s renal function during living-related donor kidney transplantation, but it would provide more reliable information if combining with serum creatinine and endogenous creatinine clearance rate.