Analysis Of Factors Affecting Prognosis Related To Living Kidney Transplantation

Objective:To investigate the factors influencing the poor recovery of graft kidney function after relative living kidney transplantation and the occurrence of postoperative complications in the recipient.Methods:Patients who underwent relative living kidney transplantation in the Department of Urology II at the First Hospital of Jilin University from January 2016 to December 2021 and were regularly followed up at our hospital were included,and the preoperative clinical indicators and follow-up data of donor recipients were retrospectively statistically analyzed to summarize information regarding time-zero renal biopsy pathological findings,prognostic nutritional index,Systemic Immune-inflammation Index,body mass index,age,dialysis mode,dialysis duration,quality of donor kidney after perfusion,the correlation between donor kidney laterality and postoperative renal function recovery in kidney transplant recipients and the occurrence of postoperative complications.Results:A total of 298 relative living kidney transplant recipients were included in the study,with a mean age of 50.5±7.2 years for donors,99(33%)for men and 199(67%)for women.The mean age of the recipients was 36.4±11.9 years,with 193 males(64.8%)and 105 females(35.2%).Postoperative DGF(delayed graft function,DGF)occurred in 12 cases,AR(Acute Rejection,AR)in 40 cases,and infection in 42 cases.Statistical results showed that increased donor kidney pathology Remuzzi score led to an increased risk of postoperative DGF with a statistically significant correlation(OR 2.247,95% CI 1.200-4.208,P=0.011).eGFR correlation between Remuzzi score and post-transplant patients at 7 days,1 month,2 months,and 6 months was statistically significant(P= 0.002,r=-0.209;P=0.003,r=-0.198;P=0.044,r=-0.134;P=0.010,r=-0.171).the correlation of increased PNI index with elevated risk of DGF was statistically significant(P=0.006,OR 1.187,95% CI 1.051-1.341).Multifactorial analysis showed statistically significant correlations between donor age and eGFR at various postoperative time periods,and between recipient BMI and eGFR in the mid-and long-term post-transplant period(1 month,2 months,6 months and 1 year);PNI,dialysis duration and early postoperative(7 days)eGFR correlations were statistically significant.Conclusions:(1)Increased donor kidney pathology Remuzzi score and PNI index elevate the risk of postoperative DGF.(2)Remuzzi score,recipient BMI,and donor age were negatively correlated with the recovery of eGFR at each period of 1 year after surgery in recipients.(3)The length of dialysis was negatively correlated with eGFR recovery at 1 week postoperatively.