nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2005-9-4-63-66nefr-723Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИ. КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯORIGINAL ARTICLES. CLINICAL INVESTIGATIONSВЛИЯНИЕ ОТСРОЧЕННОЙ ФУНКЦИИ ТРАНСПЛАНТАТА НА ВЫЖИВАЕМОСТЬ В ТЕЧЕНИЕ ГОДА ПОСЛЕ ТРАНСПЛАНТАЦИИTHE IMPACT OF DELAYED GRAFT FUNCTION ON GRAFT SURVIVAL ONE YEAR AFTER TRANSPLANTATIONРайниенеТ.RainieneT.

Клиника нефрологии и урологии

АсакиенеЕ.AsakieneE.

Клиника нефрологии и урологии

ЗелвисА.ZelvysA.

Клиника нефрологии и урологии

ТрофименкоИ. И.TrofimenkoI. I.

Перевод с английского

translation from English

Вильнюсский университетLithuania200510042005946366Copyright © Райниене Т., Асакиене Е., Зелвис А., Трофименко И.И., 20052005Райниене Т., Асакиене Е., Зелвис А., Трофименко И.И.Rainiene T., Asakiene E., Zelvys A., Trofimenko I.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/723

ЦЕЛЬ РАБОТЫ – оценить частоту ОФТ и её влияние на функцию и выживаемость трансплантата через год после трансплантации (TП) трупной почки. ПАЦИЕНТЫ И МЕТОДЫ. Данное сообщение является результатом 153 последовательных операций по трансплантации трупных почек с января 2000 по декабрь 2003 года. ОФТ наблюдалась в 16 % (26/153) ТП почек. Во всех 153 случаях были оценены частота эпизодов острого отторжения, выживаемость пациентов и их трансплантатов и функция трансплантата. Группа 1 включала 26 пациентов с ОФТ, а группа 2 (контрольная группа) – 127 больных с восстановлением функции трансплантата сразу после операции. РЕЗУЛЬТАТЫ. Не наблюдалось значимых отличий между группами по возрасту (42,2±12,9 vs 39,2±13,7) и HLA типированию (2,04 vs 2,24) реципиентов. Группы различались по числу повторно трансплантированных (1 vs 14) пациентов, HLA пресенсибилизации PRA>30% (3,8% vs 10,2%) и по возрасту доноров (41,9±13,9 vs 32,0±15,9). Значимые различия отмечены по числу доноров старше 50 лет (8/26 vs 17/127, χ2=4,7707, p<0,05; соответственно). Средняя длительность холодовой ишемии была одинаковой в обеих группах (17,1±8,0 ч и 16,3±5,7 ч; соответственно). Средняя продолжительность лечения гемодиализом после ТП составила 20,46 дней, среднее число гемодиализов после ТП – 7,8 процедур на пациента. Частота эпизодов острого отторжения была выше в группе 1 по сравнению с группой 2 – 73,0% (19/26) vs 37,8% (48/127), χ2=10,9142, p<0,05. Выживаемость пациентов и трансплантатов через год составила 93,0%, 89,0% vs 94,0%, 86,4%, соответственно. Доля пациентов с хорошей функцией трансплантата (креатинин сыворотки <130 мкмоль/л) была недостоверно выше в группе 2 (70,2% vs 60,0%, соответственно). ЗАКЛЮЧЕНИЕ. ОФТ является фактором риска острого отторжения трансплантата, но не влияет на выживаемость пациентов и пересаженных органов. Полученные данные могут использоваться для выбора протоколов иммуносуппрессии.

THE AIM of the work was to evaluate the incidence of delayed graft function (DGF) and its impact on the function and graft survival rate one year after transplantation of a cadaver kidney. PATIENTS AND METHODS. This communication is a result of 153 consecutive operations of transplantations of cadaver kidneys in the period from January 2000 through December 2003. DGF was observed in 16.9 % (26/153) of kidney transplantations. The frequency of episodes of acute rejection, the survival rate of the patients and their transplants and functions were evaluated in all 153 patients. Group 1 consisted of 26 patients with DGF and group 2 (as a control group)  of 127 patients with the graft function recovered immediately after transplantations. RESULTS. There were no significant differences between the age of the recipients (42.2± 12.9 vs 39.2 ±13.7) as well as in HLA matching (2.04 vs 2.24) between those groups. The groups differed in the number of retransplanted patients (1 vs 14), HLA presensibilization PRA>30% (3.8% vs 10.2%), and the age of the donors (41.9±13.9 vs 32.0±15.9). Significant differences were observed in the donors older than 50 years (8/26 vs 17/127), χ2 =4.7707, p< 0.05, respectively). Mean cold ischemic time was similar in both groups (17.1± 8.0 h and 16.3± 5.7 h, respectively). The mean duration of hemodialysis treatment after transplantations was 20.46 days. The mean number of hemodialysis procedures after transplantations was 7.8 procedures per patient. The occurrence of acute rejection episodes was higher in group 1 than in group 2, 73.0% (19/26) vs 37.8% (48/127), χ2 = 10.9142, p<0.05. The survival rate of the patients and transplants within a year was 93.0%, 89.0% vs 94.0%, 86.4% respectively. The portion of the patients with a good function of the graft (serum creatinin < 130 mkmol/l) was unreliably higher in group 2 (70.2% vs 60.0%; respectively). CONCLUSION. DGF is a risk factor for acute rejection, but it has no impact on the survival of the patients and grafts. The data might be used for a decision for the protocols of immunosuppression.

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The authors declare that there are no conflicts of interest present.