Changes of serum homocysteine level of renal transplant recipients / 器官移植

ABSTRACT

Objective To observe the changes of serum homocysteine (Hcy)level of renal transplant recipients before and after renal transplantation,and assess the correlation between serum Hcy level and graft function.Methods Thirty-three recipients were included into the transplantation group,who underwent renal allograft transplantation in the Organ Transplant Institute of the 309 th Hospital of People's Liberation Army and had renal function recovered stably from January 2013 to June 2014.And 65 patients who were confirmed as chronic renal failure (CRF)by clinical examinations were included into the CRF group and 30 healthy people were included into the control group.A retrospective cross-sectional study was conducted on all of these subjects.Serum Hcy,serum creatinine (Scr)and blood urea nitrogen (BUN)levels of these three groups were compared.Serum Hcy and Scr levels of the transplantation group were continuously monitored before transplantation and at 3,7,14 and 21d after transplantation.The correlation between the changes of serum Hcy levels and the renal function before and after transplantation was assessed.Results Serum Hcy level of the CRF group was (25 ±10)μmol/L,which was significantly higher than (9 ±4)μmol/L of the control group and (15 ±9)μmol/L of the transplantation group in stable period,with statistical significance (all in P <0.001).Serum Hcy level of the transplantation group was significantly higher than that of the control group(P <0.001).Scr level of the CRF group,the transplantation group and the control group was(708 ±302)μmol/L, (98 ±23)μmol/L and (72 ±18)μmol/L,respectively.Scr level of the CRF group was significantly higher than those of the transplantation group and the control group (all in P <0.001).BUN level of the CRF group, the transplantation group and the control group was (18.1 ±5.9)mmol/L,(10.9 ±5.3)mmol/L and (4.9 ± 1.3) mmol/L, respectively. BUN level of the CRF group was significantly higher than that of the transplantation group and the control group (all in P <0.001),and BUN level of the transplantation group was significantly higher than that of the control group (P <0.001).With the improvement in renal function after transplantation,Scr and serum Hcy levels of the transplantation group deceased gradually.At 14 d after transplantation,Hcy level decreased to the minimum of (15 ±5)μmol/L.Compared with (25 ±10)μmol/L before transplantation,the difference had statistical significance (P <0.05).Within 14 d after transplantation, serum Hcy level of the transplantation group was positively correlated with Scr level (r =0.761,P <0.05). Conclusions Serum Hcy level of the renal transplant recipients is correlated with the graft function.The combined detection of serum Hcy and renal function index has certain guiding significance in the prevention of hyperhomocysteinemia and the early assessment of graft function.