ABSTRACT
There is currently a huge worldwide demand for donor kidneys for organ transplantation. Consequently, numerous marginal donor kidneys, such as kidneys with microthrombi, are used to save patients' lives. While some studies have shown an association between the presence of microthrombi in donor kidneys and an increased risk for delayed graft function (DGF) (McCall et al., 2003; Gao et al., 2019), other studies have demonstrated that microthrombi negatively impact the rate of DGF (Batra et al., 2016; Hansen et al., 2018), but not graft survival rate (McCall et al., 2003; Batra et al., 2016; Gao et al., 2019). In contrast, Hansen et al. (2018) concluded that fibrin thrombi were not only associated with reduced graft function six months post-transplantation but also with increased graft loss within the first year of transplantation. On the other hand, Batra et al. (2016) found no significant differences in the DGF rate or one-year graft function between recipients in diffuse and focal microthrombi groups. To date, however, the overall influence of donor kidney microthrombi and the degree of influence on prognosis remain controversial, necessitating further research.
Subject(s)
Humans , Thrombotic Microangiopathies , Transplantation, Homologous , Tissue Donors , Kidney , AllograftsABSTRACT
Objective To evaluate the effect of gender matching on the outcomes of livingdonor renal transplantation.Methods A total of 419 cases of living-donor renal transplantation in our center were divided into male-donor-male-recipient (MDMR) group,male-donor-female-recipient (MDFR) group,female-donor-male-recipient (FDMR) group,female-donor-female-recipient (FDFR)group.The outcomes including graft and patient survival,acute rejection and renal function were analyzed retrospectively.Results Compared to MDMR group,MDFR group and FDFR group had lower Scr [(80.7±17.9),(87.4±21.9) μmol/L vs (120.3±72.5) μmol/L,all P ＜ 0.05] and uric acid (UA) [(318.1 ± 86.4),(303.5 ± 66.9) μmol/L vs (358.4 ± 77.8) μmol/L,P ＜ 0.05] 6 months after operation.Compared to MDFR group,FDMR group had higher Scr[(117.7±27.4) μmol/L vs (80.7±17.9) μmol/L,P ＜ 0.01],UA [(371.0±92.4) μmol/L vs (318.1±86.4) μmol/L,P ＜ 0.05] and lower glomerular filtration rate (GFR) [(70.4± 17.8) ml/min vs (79.6± 18.9) ml/min,P ＜ 0.05].Compared to FDMR group,FDFR group had lower Scr [(87.4±21.9) μmol/L vs (117.7±27.4) μmol/L,P ＜ 0.01] and UA [(303.5±66.9)μmol/L vs (371.092.4) μmol/L,P＜ 0.01].Compared to MDFR group,FDFR group showed lower GFR [(72.4±25.3) ml/min vs (82.7± 18.7) ml/min,P ＜ 0.05] 1 year after operation.Compared to MDMR group,FDFR group showed lower UA [(322.9±69.7) μmol/L vs (376.0±66.2) μmol/L,P ＜ 0.05] 2 years after operation.Compared to FDMR group,FDFR group showed lower Scr [(88.7 ±27.0) μmol/L vs (112.7±27.8) μmol/L,P ＜ 0.05] and UA [(318.3 ±61.2) μmol/L vs (396.2± 100.3) μmol/L,P ＜ 0.05] 3 years after operation.5 years after operation,there were no significant differences in above indexes,the incidence of slow graft function,acute rejection and survival of graft and patient among groups.Conclusions Male recipients of female donors have the worst renal function while female recipients have better outcomes after operation.