中国组织工程研究 ›› 2017, Vol. 21 ›› Issue (16): 2593-2599.doi: 10.3969/j.issn.2095-4344.2017.16.023

• 组织构建临床实践 clinical practice in tissue construction • 上一篇    下一篇

供、受者性别因素对公民逝世器官捐献供肾移植后肾功能恢复的影响

李金锋,孙佳佳,丰贵文,尚文俊,庞新路,刘  磊,谢红昌,丰永花,王志刚   

  1. 郑州大学第一附属医院肾移植科,河南省郑州市  450052
  • 修回日期:2017-01-12 出版日期:2017-06-08 发布日期:2017-06-08
  • 通讯作者: 丰贵文,博士,主任医师,教授,郑州大学第一附属医院肾移植科,河南省郑州市 450052
  • 作者简介:李金锋,男,1980年生,河南省新乡市人,汉族,2009年复旦大学毕业,博士,副主任医师,副教授,主要从事肾移植方面的研究。
  • 基金资助:

    国家自然科学基金(U1204820);郑州大学第一附属医院青年基金(2011-QN010)

Effect of donor and recipient gender on the recovery of renal function after donation after cardiac death renal transplantation

Li Jin-feng, Sun Jia-jia, Feng Gui-wen, Shang Wen-jun, Pang Xin-lu, Liu Lei, Xie Hong-chang, Feng Yong-hua, Wang Zhi-gang   

  1. Department of Kidney Transplantation, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
  • Revised:2017-01-12 Online:2017-06-08 Published:2017-06-08
  • Contact: Feng Gui-wen, M.D., Chief physician, Professor, Department of Kidney Transplantation, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
  • About author:Li Jin-feng, M.D., Associate chief physician, Associate professor, Department of Kidney Transplantation, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
  • Supported by:

    the National Natural Science Foundation of China, No. U1204820; the Foundation for the Youth of the First Affiliated Hospital of Zhengzhou University, No. 2011-QN010

摘要:

文章快速阅读:

文题释义:
肾移植:
是将健康者的肾脏移植给有肾脏病变并丧失肾脏功能的患者。肾移植因其供肾来源不同分为自体肾移植、同种异体肾移植和异种肾移植,习惯把同种异体肾移植简称为肾移植。其他两种肾移植则冠以“自体”或“异种”肾移植进行区别。
公民逝世后器官捐献:为规范器官移植工作、扩大器官来源,中国积极推行的解决当前器官供体短缺的有效途径。公民逝世后器官捐献主要包括脑死亡器官捐献(Donation after Brain Death,DBD)、心死亡器官捐献(Donation after Death,DCD)、过渡时期脑-心双死亡器官捐献(Donation after Brain Death Puls Cardiac Death,DBCD)。

 

摘要
背景:
公民逝世器官捐献逐渐成为器官移植的主要器官来源,供、受者性别因素可能在公民逝世器官捐献供肾移植前评估与受者选择中起着重要作用。
目的:分析供、受者性别因素对公民逝世后器官捐献供肾移植后肾功能恢复的影响,指导公民逝世器官捐献供肾时受者的选择。
方法:回顾性分析2012年7月至2015年3月间在郑州大学第一附属医院成功施行公民逝世器官捐献肾移植供受者临床资料。依据供、受者性别将受者分为4组:A组(男性供者,男性受者)、B组(男性供者,女性受者)、C组(女性供者,男性受者)、D组(女性供者,女性受者);随访受者移植后1,2周以及1,3,6,12个月肾功能变化,比较供、受者性别因素对移植后肾功能恢复的影响。 

结果与结论:①男性供者组受者(A+B组)移植后各时间点血肌酐值均低于女性供者组受者(C+D组),其中移植后3,6,12个月两组间差异有显著性意义(P < 0.05);②男性供者组受者(A+B组)移植后各时间点的估算肾小球滤过率均高于女性供者组受者(C+D组),移植后随访各时间点差异有显著性意义(P < 0.05);③C组(女性供者,男性受者)移植后各时间点随访血肌酐值均高于其他3组受者,差异有显著性意义(P < 0.05);移植后3,6,12个月A组(男性供者,男性受者)受者的血肌酐值高于B组(男性供者,女性受者),差异有显著性意义(P < 0.05);④A组(男性供者,男性受者)受者移植后各时间点肾小球滤过率值始终高于C组(女性供者,男性受者),差异有显著性意义(P < 0.05),B组(男性供者,女性受者)受者移植后3,6,12个月肾小球滤过率值高于D组(女性供者,女性受者)受者,随访6个月内差异无显著性意义(P 0.05),随访12个月差异有显著性意义(P < 0.05);⑤结果证实,男性供者的受者肾功能恢复优于女性供者;男性受者接受女性供肾时,其肾功能恢复相对较慢,应谨慎选择;供者年龄较大以及肾功能较差的男性供者选择体表面积较低的女性受者也能达到满意的移植效果。因此,供、受者性别因素应作为选择受者的一个参考指标。

 

 

ORCID: 0000-0002-4312-5917(李金锋)

关键词: 组织构建, 组织工程, 性别, 公民逝世器官捐献, 肾移植, 肾功能恢复, 受者选择, 边缘性供肾, 体表面积, 国家自然科学基金

Abstract:

BACKGROUND: Donation after cardiac death (DCD) is becoming the main source of organs for transplantation. Donor and recipient gender may play an important role in preoperative evaluation and recipient selection of transplantation.

OBJECTIVE: To analyze the effect of donor and recipient gender on the recovery of renal function after DCD renal transplantation, and to further guide the selection of recipients.
METHODS: The clinical data of recipients and donors of DCD kidney transplantation performed at the First Affiliated Hospital of Zhengzhou University from July 2012 to March 2015 were analyzed retrospectively. According to donor and recipient gender, the donors and recipients were divided into four groups: group A (male donor, male recipient), group B (male donor, female recipient), group C (female donor, male recipient), group D (female donor, female recipient). The renal function of the recipients was recorded at 1 and 2 weeks, 1, 3, 6, and 12 months postoperatively to compare the effect of donor and recipient gender on the recovery of renal function.

RESULTS AND CONCLUSION: The serum creatinine level in the groups A and B was lower than that in the groups C and D at postoperative different time points, and there was a significant difference at 3, 6 and 12 months postoperatively  (P < 0.05). The estimated glomerular filtration rate in the groups A and B was significantly higher than that in the groups C and D at postoperative different time points (P < 0.05). The serum creatinine level in the group C was significantly higher than that in the other three groups at postoperative different time points (P < 0.05). The serum creatinine level in the group A was significantly higher than that in the group B at 3, 6 and 12 months postoperatively (P < 0.05). The glomerular filtration rate in the group A was significantly higher than that in the group C at postoperative different time points (P < 0.05). The glomerular filtration rate in the group B was significantly higher than that in the group D at 12 months postoperatively (P < 0.05). These results suggest that the male donors show superior renal function to the female donors. The postoperative recovery of renal function is relatively slow when the male recipients receive a kidney of female donors. The female recipients with lower body surface area who receive the kidney of elderly male donors with poor renal function can achieve favorable clinical effects. Therefore, the gender should be used as a reference index for selecting potential recipients.

 

 

Key words: Kidney Transplantation, Sex Factors, Tissue Donors, Tissue Engineering

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