在活体捐赠者切除术后,肌酸激酶升高的发生率和影响
Michael Dryden1, Abraham Matar1, Fern Calkins2
1Department of Surgery, Division of Transplantation, University of Minnesota, Minneapolis, Minnesota.
Transplantation proceedings
|November 5, 2025
概括
在手术辅助的腹腔镜供体腎切除术 (HALDN) 后,肌酸激酶 (CK) 水平升高是常见的,但临床上显著的狂肌痛是罕见的. 男性性别和更长的手术时间是危险因素,但CK升高不会影响中期功能.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植手术 移植手术
- 生物化学 生物化学
背景情况:
- 活捐赠 (LKD) 后肌酸激酶 (CK) 水平升高的临床意义尚不清楚.
- 肌酸激酶是一种主要存在于肌肉中的酶,高水平可以表明肌肉受损.
研究的目的:
- 调查手术辅助腹腔镜供体切除术 (HALDN) 后CK水平升高的发生率和临床意义.
- 确定与显著的CK升高相关的风险因素,并评估它们对捐赠后功能的影响.
主要方法:
- 对264名连续接受HALDN.的捐赠者进行了回顾性分析.
- 术后的CK水平在术后的0 (POD0) 和1 (POD1) 天被监测,如果有指示,则进行POD2测试.
- 血清肌素和六个月估计的淋巴球过率 (eGFR) 是主要结果指标.
主要成果:
- 中位数CK水平从POD0显著增加到POD1和POD2.
- 临床显著的CK升高 (>1000U/L) 在8.7%的捐赠者中发生;2.3%的捐赠者超过5000U/L.
- 男性性别,更高的捐赠前肌素和更长的手术时间与高的CK水平有关. 在六个月后,CK升高和降低eGFR之间没有发现相关性.
结论:
- 经过HALDN后,CK水平升高是常见的,但严重的狂骨髓溶解是罕见的.
- 常规CK监测有助于早期检测亚临床狂犬病.
- 过渡性CK升高似乎不会影响活体脏捐赠者的中期功能.
相关概念视频
01:26Kidney Transplant II: Surgical Procedure
297
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
297
01:28Kidney Transplant I: Introduction
321
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
321
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
255
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
255
01:29Acute Kidney Injury III: Clinical Manifestations
802
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
802
01:22Acute Kidney Injury I: Introduction
554
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
554
01:16Kidney Transplant III: Nursing Management
304
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
304