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Conteo Sanguíneo Completo en la Disfunción Tardía del Injerto: Una Revisión Narrativa

Marlene Marisol Perales-Quintana1, Edelmiro Perez Rodriguez2, Allina P Flores-Mendoza2

  • 1Department of Physiology, Facultad de Medicina, Universidad Autónoma de Nuevo León (UANL), Monterrey, Mexico.

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Los parámetros del conteo sanguíneo completo (CSC) pueden ayudar a predecir la disfunción tardía del injerto (DGF) después de los trasplantes de riñón. La baja hemoglobina y la elevada relación neutrófilos-linfocitos (NLR) se asocian con un mayor riesgo de DGF, lo que sugiere una monitorización accesible.

Palabras clave:
trasplante de riñóndisfunción tardía del injertoconteo sanguíneo completohemoglobinarelación neutrófilos-linfocitos

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Área de la Ciencia:

  • Nefrología
  • Inmunología de Trasplantes
  • Hematología

Sus antecedentes:

  • La disfunción tardía del injerto (DGF) es una complicación frecuente después del trasplante de riñón, que causa lesión renal aguda y requiere diálisis.
  • La identificación temprana de pacientes en riesgo de DGF es vital para mejorar la atención perioperatoria y los resultados del trasplante.
  • Los biomarcadores novedosos actuales para la DGF carecen de aplicación clínica generalizada.

Objetivo del estudio:

  • Revisar el potencial de los parámetros del conteo sanguíneo completo (CSC) y los índices derivados como predictores accesibles y rentables del riesgo de DGF en el trasplante de riñón.
  • Sintetizar la investigación existente sobre la asociación entre los parámetros del CSC y la DGF.

Principales métodos:

  • Revisión narrativa de estudios que investigan parámetros del CSC (hemoglobina, glóbulos blancos, recuento de plaquetas) e índices hematológicos (NLR, PLR) en relación con el riesgo de DGF.
  • Búsqueda bibliográfica realizada en las principales bases de datos biomédicas utilizando palabras clave específicas.
  • Análisis de estudios seleccionados por su valor predictivo, mecanismos subyacentes y utilidad clínica.

Principales resultados:

  • Se encontraron asociaciones significativas entre parámetros específicos del hemograma y el riesgo de DGF.
  • La baja hemoglobina pre/perioperatoria y la NLR elevada pre/post-trasplante se correlacionan con un mayor riesgo de DGF.
  • La baja hemoglobina pre-trasplante y las caídas perioperatorias >1.3 g/dL, junto con una NLR preoperatoria >3.5, muestran potencial para la detección temprana.

Conclusiones:

  • Los parámetros derivados del CSC, en particular los niveles de hemoglobina y la NLR, muestran potencial para predecir el riesgo de DGF en receptores de trasplantes de riñón.
  • Estos parámetros pueden reflejar las respuestas inflamatorias subyacentes y la lesión por isquemia-reperfusión.
  • Se necesitan más estudios prospectivos multicéntricos para validar los hallazgos y establecer valores de corte estandarizados para uso clínico.