The Study Of Dependablity Between Cognate Transplanted Donor Kidney Volume And Renal Function On Postgraft

Objective:Measure the living related kidney transplantation donor kidney volume, to study the dependablity between donor kidney volume and long term survival rate of postgraft kindey.(definition of long term survival rate:patients surviving more than6months after renal transplantation), provid preoperative screening conditions for living related transplanted kidney donor, in order to improve the long term survival rate of living relative kidney postgraft patients.Materials and methods:The study objects were carried out in two stages, they were collected from two part of patients.The first stage:30cases donor were collected in organ transplantation center of the First Affiliated Hospital of Kunming Medical University, used for living related renal transplantation from2010July to2011October. Divided into A, B, C three group according to intraoperative actual renal size,10cases in each group. In the preoperative, calculate acromegalic surface area respectively on the basis of surface area calculation formula, measured the donor kidney volume by two-dimensional and three-dimensional ultrasound, then measured intraoperative donor kidney volume and weight. At last, compared the variability between ultrasonographic renal volume and actual renal volume, dependablity between surface area and kidney size. Sampling and grouping criteria:(gender, age, the left kidney does not belong to the subgroup standard); aged35-56years (mean46.2years); in30cases of donor kidney volume mean was130.13±7.642cm3,130.13cm3was the median, grouped A for less than10%median (m3), B for10%(m3) median, C for more than10%(m3) median; the left kidney.The second stage:in our department in200205to2007July living-related renal transplantation patients sampling from60donors and recipients in clinical and follow-up data.Retrospective statistical analysis, studies of living kidney transplantation donor kidney volume and long-term graft survival rate correlation.Sampling and grouping criteria donor:(1) directly under the kinship, physical health, voluntary donations;(2) at the age of36-58years (mean47.2years);(3) of60patients with renal volume and the recipient body surface ratio is divided into three groups, namely the donor kidney volume/recipient body surface area the ratio of E group:75.19-80.24,81.33-85.21. G group and>86.76F group,20cases in each group;(4) ABO share the same blood type:(5) HLA matching>3site pairing;(6) lymph cross test negative;(7) donor kidney to the left kidney.Recipients:(1) in end-stage renal disease, no operation contraindications;(2) preoperative blood dialysis for a period of2.4months to6.2months (average4.3months):(3) a history of failure;(4) the first graft;(5) of60patients with left Shenjun transplantation in the right iliac fossa;(6) the warm ischemia time in the graft l～2.5min (average1.75min), cold ischemia time ranged from20.4to50.7(average35.55min);(7) no postoperative hyperacute or acute rejection;(8) excluded from transplantation of technical complications.Result:The postoperative follow-up information for E, F, G three recipients group were processed by SPSS17.0statistical software, the results showed that:In the postoperative short-term and long-term graft function and structure. it was statistically significant difference comparing group E to groups G (P<0.05).1year survival rate of group E, F, G was all100%.2year survival rate of group E was92.7%, group F95.5%, group G98.3%, the two of three group was no statistical difference;3year survival rate of group E, F, G was respectively83.4%,89.6%,95.2%, group E contrasting group G had obviously difference (p=0.025, P<0.05).5year survival rate was respectively63.7%,76.4%,82.5%for three group; the two of three group was significant difference all (p=0.047, P<0.05).Conclusion:This study was to measure the volume and weight of the living-related renal transplantation donor kidney, every donor had different body surface area. and combined with a retrospective statistical analysis for5years follow-up information in60cases, the size ratio of donor kidney volume/recipients body surface area was different, study the correlation of donor kidney volume and long-term graft survival rate, derived the conclusions as follows:(1) surface area and volume of kidney size is positive correlation, there was significant difference (p=0.018. P<0.05),(2) preoperative ultrasonographic donor kidney volume consistented with renal actual volume, three-dimensional ultrasound was minimum difference. has good accuracy and repeatability.(3) function graft renal unit gross absolutely or relative insufficiency in volume dose effected long-term graft survival related.(4) renal volume related to renal unit gross.(5) donor kidney volume related to long-term renal allograft size and elevated vascular resistance rate correlation.(6) after renal transplantation, the renal function of donor kidney makro-volume recovered quickly.(7) donor kidney volume is associated with long-term allograft renal function.(8) donor kidney volume had correlation with long-term graft survival rate.(9) the size of donor kidney for living related kidney transplantation can be used to screen renal transplantation preoperative donor in clinical work, it was an significant method, was helpful to improve the success rate of renal transplantation operation, can improve the patients'life quality and long-term survival after operation.