| Background With the improvement of surgical technique,transplantation immunity,the progress of basic research as well as the new type of immunosuppressant constantly,kidney transplantation has become end-stage renal disease(endstage takes diseases,ESRD)patients the best alternative treatments.Since 1954,the first kidney transplant successfully in the human body to carry out up to now,renal transplantation has saved the lives of millions of patients with ESRD.As for the shortage of renal and wait for the contradiction between the growing Numbers of renal transplant patients is rising,relatives living donor renal transplantation has become one of the important ways to solve for the shortage of kidney.According to incomplete statistics,the number of renal transplantation in our country 7000 ~ 8000 times a year,which accounts for about 20% of living renaltransplan-tation,but compared with developed countries in the world living renal transplantation gap is still large.In addition to the state of the economy and traditional ideas,the influence of donor screening standard strictly,will suffer from kidney or kidney benign disease and affected by a series of problems such as older donors excluded,causing kidney was the waste of resources.Therefore how to reasonable use of this kind of marginal donor,safely and effectively relieve the contradictions of the living donor kidney shortage,more and more get the attention of people.Objective Objectiveto explore the clinical effect of the application of the marginal donor in the living related kidney transplantation,and to provide a useful basis for clinical workers.Methods Randomly selected 200 cases of living related renal transplantation in the organ transplantation center of Zhengzhou people's Hospital from January 1,2012 to March 1,2014.According to the donor,it was divided into two groups: the marginal donor group and the standard donor group.The study group was divided into 60 groups.The standard donor group was set as control group,140 cases in each group.The team in the donor age 60 or higher 18 cases;Obesity donor(BMI ?28 kg/m2),10 cases;10 cases of high blood pressure donor;Diabetes donor in 8 cases;There were 10 cases of mild and moderate stenosis of the renal artery,and the lesions were located at the beginning of the renal artery;Kidney stones in 2 cases,stone diameter 2 mm,4 mm respectively;Renal cyst in 2 cases,cyst diameter of 20 mm,25 mm respectively.The clinical data of two groups were followed up for a period of 36 months.Comparison of two groups after renal transplantation for 1 weeks,January,March,June,December,24 months and 36 months,estimated glomerular filtration rate(glomerular,filtration rate estimates,e GFR),postoperative liver function abnormalities,acute rejection,delayed graft function(delayed graft,function,DGF),lung the infection,the incidence of surgical complications and postoperative complications,as well as the 1 and 3 year patient / graft survival rate.Results The e GFR receptor levels in the study group was lower than that of the control group.The study group after 1 weeks e GFR receptor levels compared with the control group,the difference was statistically significant(t =1.762,P<0.05);January,March,June,12 months,24 months and 36 months after operation e GFR receptor levels in the study group compared with the control group receptor,the difference was not statistically significant(t =1.143?P >0.05,t =1.281?P >0.05,t =1.681?P >0.05,t =1.262?P >0.05,t =1.131?P >0.05,t =1.331?P >0.05).marginal donor group receptor with non marginal donor group of recipients after 1 years and 3 years survival rates were 98.3%/100% and 94.9%/98.6%,the difference between the two groups were not statistically significant(?2=2.311?P>0.05,?2=2.234?P>0.05).Marginal donor group receptor and non edge donor group of recipients after renal transplantation for 1 years,3 years survival rate were 98.3%/99.3%,91.6%/96.4%,the difference between the two groups were not statistically significant(?2=2.946?P>0.05,?2=2.017?P>0.05);marginal donor group receptor and non edge liver function damage for the group of recipients after renal acute rejection,DGF,pulmonary infection,surgical complications,the difference between the two groups were not statistically significant(?2=1.159?P>0.05,?2=1.685?P>0.05,?2=2.681?P>0.05,?2=1.184?P>0.05,?2=1.492?P>0.05).Conglusions Edge for renal receptor of the early clinical effect can be,should strictly control it into standard.Edge for kidney to receptor,the influence of the graft function for a long time,still need to continue to observe.In the case of the current demand for kidney,edge for kidney can be selectively as one of effective ways to enlarge the source of living donor kidney. |
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