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背景:公民逝世器官捐献逐渐成为器官移植的主要器官来源,供、受者性别因素可能在公民逝世器官捐献供肾移植前评估与受者选择中起着重要作用。目的:分析供、受者性别因素对公民逝世后器官捐献供肾移植后肾功能恢复的影响,指导公民逝世器官捐献供肾时受者的选择。方法:回顾性分析2012年7月至2015年3月间在郑州大学第一附属医院成功施行公民逝世器官捐献肾移植供受者临床资料。依据供、受者性别将受者分为4组:A组(男性供者,男性受者)、B组(男性供者,女性受者)、C组(女性供者,男性受者)、D组(女性供者,女性受者);随访受者移植后1,2周以及1,3,6,12个月肾功能变化,比较供、受者性别因素对移植后肾功能恢复的影响。结果与结论:(1)男性供者组受者(A+B组)移植后各时间点血肌酐值均低于女性供者组受者(C+D组),其中移植后3,6,12个月两组间差异有显著性意义(P<0.05);(2)男性供者组受者(A+B组)移植后各时间点的估算肾小球滤过率均高于女性供者组受者(C+D组),移植后随访各时间点差异有显著性意义(P<0.05);(3)C组(女性供者,男性受者)移植后各时间点随访血肌酐值均高于其他3组受者,差异有显著性意义(P<0.05);移植后3,6,12个月A组(男性供者,男性受者)受者的血肌酐值高于B组(男性供者,女性受者),差异有显著性意义(P<0.05);(4)A组(男性供者,男性受者)受者移植后各时间点肾小球滤过率值始终高于C组(女性供者,男性受者),差异有显著性意义(P<0.05),B组(男性供者,女性受者)受者移植后3,6,12个月肾小球滤过率值高于D组(女性供者,女性受者)受者,随访6个月内差异无显著性意义(P≥0.05),随访12个月差异有显著性意义(P<0.05);(5)结果证实,男性供者的受者肾功能恢复优于女性供者;男性受者接受女性供肾时,其肾功能恢复相对较慢,应谨慎选择;供者年龄较大以及肾功能较差的男性供者选择体表面积较低的女性受者也能达到满意的移植效果。因此,供、受者性别因素应作为选择受者的一个参考指标。
Background: The donation of citizen’s death organ gradually becomes the main organ source for organ transplantation. The sex factor of donor and recipient may play an important role in assessing and selecting the recipient before donor organ donation for kidney transplantation. OBJECTIVE: To analyze the influence of donor and recipient gender factors on the recovery of renal function after donor’s donation for renal transplantation after the death of citizens, and to guide the choice of recipients when citizens died. Methods: A retrospective analysis of the clinical data of donor recipients who died of kidney donation during July 2012 to March 2015 at the First Affiliated Hospital of Zhengzhou University was retrospectively analyzed. The recipients were divided into 4 groups according to their sex and recipient’s gender: group A (male donor, male recipient), group B (male donor, female recipient), group C (female donor, male recipient) Group D (female donor and female recipient). The changes of renal function at 1 week, 2 weeks, 1, 3, 6 and 12 months after transplantation were compared, and the influence of gender factors on the recovery of renal function after transplantation . RESULTS AND CONCLUSION: (1) Serum creatinine values were lower in recipients of male donor group (A + B group) than those in female donor group (C + D group) at 3, 6, (P <0.05). (2) The estimated glomerular filtration rate at each time point after transplantation in the male donor group (A + B group) was higher than that in the female donor group (P <0.05). (3) The serum levels of creatinine were significantly different in group C (female donor and male recipient) at each time point after transplantation (P <0.05). The serum creatinine values in group A (male donor and male recipient) at 3, 6 and 12 months after transplantation were significantly higher than those in group B Group (male donor, female recipient), the difference was significant (P <0.05); (4) Group A (male donor, male recipient) recipients of glomerular filtration rate (P <0.05). The recipients in group B (male donor and female recipient) were significantly younger than those in group C (female donor and male recipient) at 3, 6 and 12 months after transplantation The ball filtration rate was higher than those in group D (female donor and female recipient). There was no significant difference within 6 months after follow-up (P≥0.05) (P <0.05). (5) The results confirmed that recipients of male donors had better renal function recovery than female donors. When male recipients received female donors, renal function recovery was relatively slow, and should be carefully chosen ; Donor recipients older and less well-performing male donors also achieved satisfactory graft outcomes for women who chose to have a lower body surface area. Therefore, the gender of the donor and the recipient should be used as a reference index for selecting recipients.