Multivariate Analysis Of TRAS In Renal Transplantation After Citizen's Death Donation

Background:Kidney transplantation is the most effective treatment for end-stage renal disease in current medical environment.Among the various complications that occurred after kidney transplantation,the most common vascular complications is transplanted renal artery stenosis(TRAS).TRAS usually occurs between 3 months and 2 years after kidney transplantation,and occurs most frequently in the first 6 months,but can occur at any time,which is one of the reasons for the premature loss of graft recipients.TRAS usually occurs near the surgical anastomosis,but pre-anastomotic or post-anastomotic stenosis may also occur.Different parts and times of the onset of the disease may be a reflection of a particular cause.TRAS can occur in a variety of causes.Methods:In this study,28 patients with transplanted renal artery stenosis who underwent renal artery angiography or CTA diagnosis after renal transplantation from January 2012 to October 2018 were retrospectively analyzed.A multivariate analysis of 93 non-TRAS recipients with stable blood pressure and stable renal function was performed.To analyze the correlation between DCD,DBD era TRAS and donor kidney cold/warm ischemia time,donor and recipient clinical infection,AR,DGF,warm ischemia time,preoperative blood phosphorus,blood calcium level,postoperative blood calcium level and so on.Results:A two-class multivariate logistic regression model was fitted using a backward method.The variables that were finally included in the model were whether pediatric donor kidney and urine virological indicators were positive;the model test results:?2=9.119,P=0.010<0.05,indicating that the regression model was established.Whether the variables in the model were donor kidney(OR95%CI =1.10?6.884,P=0.031<0.05)were statistically significant,and whether the variable urinary virulence index was positive in the model(OR95%CI = 1.001-8.524,P=0.050(0.49872)= 0.05)The difference was statistically significant.In this study,it was found that children's donor kidneys,especially infants and young children,were independent risk factors for TRAS.The urinary virology index(CMV)TRAS group was significantly different from the non-TRAS group,but there was no significant difference in blood CMV index.The data of this group did not show cold ischemia time,clinical infection of donors and recipients,AR,DGF,warm ischemia time,preoperative blood phosphorus,blood calcium level,postoperative blood calcium level and so on.Conclusion:due to the shortage of donor kidney since the time of organ donation,in order to avoid the waste of donor kidney,we should expand the application of standard child donor kidney to adult recipients without suitable recipients in children.Although the failure of renal transplantation due to surgical complications was avoided,the risk of renal artery stenosis after transplantation was significantly different from that of adult donors.There was significant difference in urine virology between(CMV)TRAS group and non-TRAS group,but there was no significant difference in blood CMV index.The error in detection was not ruled out.CMV infection was considered as an independent risk factor for renal artery stenosis in transplantation.And this group of information is not statistically available.There were significant differences in cold ischemia time,clinical infection of donor and recipient,hot ischemia time of AR,DGF,preoperative blood phosphorus,blood calcium level and postoperative blood calcium level between the two groups.