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目的:探讨横纹肌溶解症合并急性肾损伤(AKI)供者肾移植后受者的临床效果。方法:回顾性分析中山大学附属第一医院2012年1月~2015年12月器官捐献供者中,因横纹肌溶解症导致AKI的供者和肾移植受者临床资料。结果:8例供者因横纹肌溶解症导致AKI,供者血肌酸激酶峰值为10 623±3 692 U/L,血浆肌红蛋白峰值为20 618±7 959μg/L,血清肌酐峰值为483±176μmol/L。其中3例接受血浆置换治疗,2例行持续性肾脏替代治疗(CRRT),1例接受体外膜肺氧合治疗。16例受者,肾移植术后4例移植肾功能延迟恢复,4例移植肾功能缓慢恢复,其余8例受者移植肾功能恢复良好。随访6~46月,人肾均存活。术后6月和12月肾小球滤过率分别为65.4±13.5 ml/(min·1.73m2)和71.2±14.3 ml/(min·1.73m2)。结论:接受横纹肌溶解症合并AKI患者供肾的受者肾移植术后移植肾功能恢复良好。出现AKI的器官捐献供者应该常规行横纹肌溶解症筛查。
Objective: To investigate the clinical effect of rhabdomyolysis combined with acute kidney injury (AKI) donor recipients after kidney transplantation. Methods: The clinical data of donor and kidney transplant recipients with rhabdomyolysis due to rhabdomyolysis were retrospectively analyzed in the donors of organ donation from January 2012 to December 2015 in the First Affiliated Hospital of Sun Yat-sen University. Results: In 8 donors, AKI was induced by rhabdomyolysis, the peak of creatine kinase was 10 623 ± 3 692 U / L, the peak of plasma myoglobin was 20 618 ± 7 959 μg / L and the peak of serum creatinine was 483 ± 176 μmol / L. Of these, 3 received plasma exchange, 2 received continuous renal replacement therapy (CRRT), and 1 received extracorporeal membrane oxygenation. Among the 16 recipients, 4 cases of renal allograft function delayed recovery after renal transplantation, 4 cases of renal graft function recovered slowly, and the other 8 cases of recipients recovered well. Follow-up from 6 to 46 months, the human kidney are alive. Glomerular filtration rates at June and December were 65.4 ± 13.5 ml / (min · 1.73 m 2) and 71.2 ± 14.3 ml / (min · 1.73 m 2), respectively. CONCLUSIONS: Recipients of kidney recipients with rhabdomyolysis and AKI recovered well after transplantation. Organ donor donors who have AKI should routinely undergo rhabdomyolysis screening.