目的 探讨亲属活体供肾肾小球滤过率与受者体重比值(Dg/Rw)对移植肾术后早期肾功能的的预测作用.方法 回顾性分析2014年1月至2015年7月间108例亲属活体肾移植的供、受者资料,排除:非首次移植或联合移植者;术后发生肾功能恢复延迟(DGF)者;术后1年随访期内发生超急性、加速性、急性排斥反应者;术后检查提示肾动脉狭窄和移植肾肾积水者,最终纳入90例.根据Dg/Rw将90例受者分为G1组(Dg/Rw≤0.81,25例)、G2组(0.82<Dg/Rw< 1.11,36例)、G3组(Dg/Rw≥1.12,29例).观察三组受者术后3d、7d、1个月、1年的血肌酐水平与Dg/Rw的关系.结果 受者术后3d、7d、1个月及1年血肌酐均与Dg/Rw呈线性关系(P<0.05).术后1年内,G1、G2组血肌酐均高于G3组(P<0.05),且G1、G2组早期血肌酐下降趋势也较G3组慢(P<0.05);但G1、G2组之间不同时间点血肌酐值的差异无统计学意义.结论 Dg/Rw较高的受者术后早期肌酐水平下降较快,且维持在较低水平.Dg/Rw对肾移植后早期受者肾功能有一定的预测作用.
Objective To investigate whether the donor's glomerular filtration rate (GFR) to recipient's weight ratio (Dg/Rw) is a useful tool to predict early clinical outcome in living-related do-nor transplantation.Methods A total number of 108 living donor transplant recipients in the Chinese Military 309th Hospital from Jan.2014 to July 2015 were enrolled in this study.The patients who had multi-organ transplantation or developed grafts rejection,delayed graft function,hydronephrosis or renal vascular stenosis were excluded.The 90 qualified recipients were divided into G1 group (Dg/Rw ≤0.81),G2 group (Dg/Rw 0.81~1.11),and G3 group (Dg/Rw≥1.12).We respectively analyzed the relationship between recipient's serum creatinine Scr and Dg/Rw at 3-,7-,30-day and 1 year after transplantation.Results Scr at 3-,7-,30-day and 1 year after transplantation had linear correlation with Dg/Rw.As compared with G1 and G2 groups,Scr level was significantly reduced in G3 group at different time points (P〈0.05).Conclusion Dg/Rw has a negative relationship with Scr level after renal transplantation.Pre-transplant Dg/Rw is a potential index to predict the early clinical outcome in living-related donor transplantation.