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DCD供肾灌注液生物标志物预测肾移植术后移植物功能延迟恢复的临床应用研究

李馨 孙泽家 蔡继飞 王玮

李馨, 孙泽家, 蔡继飞, 等. DCD供肾灌注液生物标志物预测肾移植术后移植物功能延迟恢复的临床应用研究[J]. 器官移植, 2021, 12(2): 209-214. doi: 10.3969/j.issn.1674-7445.2021.02.012
引用本文: 李馨, 孙泽家, 蔡继飞, 等. DCD供肾灌注液生物标志物预测肾移植术后移植物功能延迟恢复的临床应用研究[J]. 器官移植, 2021, 12(2): 209-214. doi: 10.3969/j.issn.1674-7445.2021.02.012
Li Xin, Sun Zejia, Cai Jifei, et al. Clinical application of biomarkers in DCD donor kidney perfusate for predicting delayed graft function after renal transplantation[J]. ORGAN TRANSPLANTATION, 2021, 12(2): 209-214. doi: 10.3969/j.issn.1674-7445.2021.02.012
Citation: Li Xin, Sun Zejia, Cai Jifei, et al. Clinical application of biomarkers in DCD donor kidney perfusate for predicting delayed graft function after renal transplantation[J]. ORGAN TRANSPLANTATION, 2021, 12(2): 209-214. doi: 10.3969/j.issn.1674-7445.2021.02.012

DCD供肾灌注液生物标志物预测肾移植术后移植物功能延迟恢复的临床应用研究

doi: 10.3969/j.issn.1674-7445.2021.02.012
基金项目: 

首都临床特色应用研究与成果推广 Z171100001017055

详细信息
    作者简介:

    李馨,女,1991年生,硕士,研究方向为泌尿外科,Email:oa9866@hotmail.com

    孙泽家,男,1990年生,硕士,研究方向为泌尿外科,Email:mnwkszj5076@163.com

    通讯作者:

    王玮,男,1973年生,博士,主任医师,研究方向为泌尿外科(肾移植方向),Email: weiwang0920@163.com

  • 李馨和孙泽家为共同第一作者
  • 中图分类号: R617

Clinical application of biomarkers in DCD donor kidney perfusate for predicting delayed graft function after renal transplantation

More Information
  • 摘要:   目的  探讨心脏死亡器官捐献(DCD)供肾静态冷保存(SCS)灌注液生物标志物预测肾移植受者术后发生移植物功能延迟恢复(DGF)的可行性。  方法  回顾性分析DCD供肾肾移植的64例受者和47例供者的临床资料。根据受者术后是否发生DGF分为DGF组(7例)与即刻肾功能恢复(IGF)组(57例),比较两组供肾SCS灌注液中4种生物标志物中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肝型脂肪酸结合蛋白(L-FABP)、白细胞介素-18(IL-18)、肾损伤分子-1(KIM-1)的水平并分析其与DGF的相关性,分析各生物标志物对肾移植受者术后发生DGF的预测价值。  结果  DCD供肾肾移植受者术后DGF的发生率为11%(7/64)。DGF组供肾灌注液的NGAL水平高于IGF组(P=0.009),供肾灌注液的NGAL水平与肾移植受者术后DGF的发生呈正相关(r=0.430, P < 0.001)。受试者工作特征(ROC)曲线分析结果显示,灌注液中的NGAL和KIM-1水平升高对肾移植受者术后发生DGF具有一定的预测价值(均为P < 0.05),当联合检测NGAL和KIM-1时,预测肾移植受者术后发生DGF的曲线下面积(AUC)为0.932[95%可信区间(CI)0.850~1.000],灵敏度为1.000,特异度为0.754(P < 0.05)。  结论  DCD供肾SCS灌注液中的NGAL水平与肾移植受者术后DGF的发生存在相关性,联合检测灌注液中的NGAL和KIM-1水平可以较为准确地预测肾移植受者术后DGF的发生。
    1)  李馨和孙泽家为共同第一作者
  • 图  1  两组DCD供肾灌注液中各生物标志物水平的比较

    注:与IGF组比较,aP < 0.05。

    Figure  1.  Comparison of biomarker levels in DCD donor kidney perfusate between two groups

    图  2  各生物标志物预测肾移植受者术后发生DGF的ROC曲线分析

    Figure  2.  ROC curve analysis of each biomarker for predicting DGF in recipients after renal transplantation

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出版历程
  • 收稿日期:  2020-12-20
  • 网络出版日期:  2021-03-19
  • 刊出日期:  2021-03-15

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