评估肾移植术后移植肾质量的指标

Indicators for Assessing the Quality of the Transplanted Kidney after Renal Transplantation

摘要: 肾移植是终末期肾衰竭的首选治疗方法，在器官移植过程中，器官在获取、保存和再灌注后都会受到缺氧缺血性损伤(ischemia-reperfusion injury, IRI)。IRI是器官血流短暂减少或停止，血流再灌注引发炎症产生的结果。肾脏对IRI敏感，IRI与一系列肾移植术后并发症有关，包括移植肾功能延迟恢复(delayed graft function, DGF)、移植物排斥、慢性移植物功能障碍以及严重的急性肾损伤(acute kindey injury, AKI)，可增加住院患者死亡率。IRI引起肾脏损伤的主要原因之一是它可引起肾脏微循环发生障碍，在移植肾恢复灌注时可导致循环灌注不足，而器官灌注的质量和充分性是至关重要的，并且与围手术期管理、治疗策略和移植物结果相关。本综述主要是总结临床中可以用于评价肾移植术后移植肾功能的各项指标。

Abstract: Kidney transplantation is the treatment of choice for end-stage renal failure, and during organ transplantation, organs are subjected to hypoxic-ischemic injury (IRI) after acquisition, preserva-tion and reperfusion (ischemia-reperfusion injury, IRI). IRI is the result of transient reduction or cessation of blood flow to an organ, with reperfusion triggering the production of inflammation. The kidneys are sensitive to IRI, and IRI is associated with a range of post-transplant complications, in-cluding delayed graft function (DGF), graft rejection, chronic graft dysfunction, and severe acute kindey injury AKI, which increases inpatient mortality. IRI is the main cause of kidney injury. One of the main causes of renal injury is the impairment of renal microcirculation, which can lead to in-adequate circulatory perfusion when perfusion is restored to the transplanted kidney, whereas the quality and adequacy of organ perfusion is critical and correlates with perioperative management, therapeutic strategies and graft outcome. The present review focuses on a summary of clinical indi-cators that can be used to evaluate renal function of kidney transplant recipients after renal trans-plantation.