摘要
目的：回顾性分析３４５ 例肾移植患者早期肾功能变化，探讨肾移植术后肾功能恢复正常所需时间长短对移植肾长期存活的影响。 方法：根据本组肾功能恢复正常平均时间为９ 天，分为即刻肾功能恢复（ Ｉ Ｇ Ｆ，术后９ 天内血肌酐降至正常） 、缓慢肾功能恢复（ Ｓ Ｇ Ｆ，大于９ 天后血肌酐才正常） 和肾功能未能恢复正常（ Ａ Ｇ Ｆ） 三组，通过 Ｋａｐｌａｎ Ｍｅｉｅｒ 方法分别计算包括急性排斥（ Ａ Ｒ） 、肾功能延迟恢复（ Ｄ Ｇ Ｆ） 和不考虑 Ａ Ｒ， Ｄ Ｇ Ｆ 时的移植肾短期和长期生存率。 结果： Ｓ Ｇ Ｆ和 Ａ Ｇ Ｆ 组患者有较高 Ａ Ｒ 和 Ｄ Ｇ Ｆ 发生率，但不管是否存在 Ａ Ｒ 和 Ｄ Ｇ Ｆ， Ｉ Ｇ Ｆ 组患者移植肾长期存活率明显高于其它两组。 结论：移植肾功能早期恢复时间及能否恢复正常明显影响移植物长期生存率。
OBJECTIVE To investigate the effect of initial graft function on renal allograft survival. METHODOLOGY Between May 1988 and December 1996,a total of 345 cadaveric renal transplantation were performed in our center.The mean time of recovering normal allograft function is 9 2 days after kidney transplantation.Recipients were grouped by initial graft function into:①those with immediate graft function,defined by serum creatinine level<132 5 μmol/L within 9 post operative days(POD);②those with slow graft function(SGF),defined by serum creatinine level>132 6 μmol/L within 9 postoperative days(POD);③those with abnormal graft function,defined by serum creatinine>132 6 μmol/L any time on POD,but without need for dialysis.Graft survival was determined in each group by Kaplan Meier method and compared by generalized log rank test. RESULTS Rejection and DGF were more frequently diagnosed in patients with SGF and AGF than in patients with IGF.Allograft survivals at 1,2 and 5 years were longer in patients with IGF than in patients with SGF or AGF,when rejection and DGF were presented( P <0 01).It held true even in terms of long term renal survival in patients with IGF when rejection and/or DGF were excluded.Graft survivals in patients with AGF at both short and long term were poor. CONCLUSION Recovery of early renal function remarkably affects allograft long term survival.
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
1999年第4期338-341,共4页
Chinese Journal of Nephrology,Dialysis & Transplantation
