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已故捐赠者的尿液Dickkopf-3与移植移植后的未来全移植功能有关
Jonathan de Fallois1, Anna Günzel1, Christoph Daniel2
1Division of Nephrology, Department of Internal Medicine, University Medical Center Leipzig, Leipzig, Germany.
概括
脏捐赠者的尿液Dickkopf-3 (uDKK3) 预测了移植成功. 较高的捐赠者DUKK3水平与较差的合移植功能相关,这表明DUKK3是器官质量评估的生物标志物.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植免疫学 移植免疫学
- 发现生物标志物的发现.
背景情况:
- 预测移植后的基移植功能仍然是一个重大的临床挑战.
- 需要新的生物标志物来评估捐赠器官的质量并指导移植决策.
- 尿液Dickkopf-3 (uDKK3) 已经成为脏捐献中的潜在生物标志物.
研究的目的:
- 调查捐赠者尿中的Dickkopf-3 (uDKK3) 水平是否反映了脏器官的质量.
- 为了确定捐赠者DUKK3与未来移植功能之间的关联.
- 评估DUKK3作为移植中供体选择的非侵入性生物标志物.
主要方法:
- 未来的多中心试验试验涉及95名已故和46名活着的脏捐赠者.
- 在捐赠者腎切除前尿样中测量尿液Dickkopf-3/肌素 (uDKK3/crea) 的比率.
- 已故捐赠者受体的分层,基于捐赠者DKK3/crea水平的中位数和估计的淋巴细胞过率 (eGFR) 和临床结果的分析.
主要成果:
- 在腎切除術前的DUKK3/Crea水平在已故的捐贈者中相比於活著的捐贈者 (9888 pg/mg vs 113 pg/mg) 顯著較高.
- 移植后3个月,来自较低DKK3/crea水平 (中位数以下) 的捐赠者的移植接受者表现出更高的估计球过率 (eGFR) (56.3毫升/分钟/1.73平方米 vs 44.2毫升/分钟/1.73平方米).
- 较低的捐赠者DKK3/crea水平与复合终点 (死亡,全移植失败或>50%的eGFR下降) 的发生率降低相关,DKK3/crea独立预测了移植后的eGFR.
结论:
- 捐赠者尿液Dickkopf-3 (uDKK3) 是一个有希望的反映脏器官质量的非侵入性生物标志物.
- 较高的捐赠者DUKK3水平与未来移植功能下降有关.
- uDKK3有可能有助于供体选择和改善移植结果.
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