南方医科大学学报 ›› 2014, Vol. 34 ›› Issue (03): 414-.

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西北地区开展公民心脏死亡后捐献肾脏移植的报告

潘晓鸣,薛武军,刘林娟,项和立,丁晨光,何术琴,任莉,田普训,丁小明   

  • 出版日期:2014-03-20 发布日期:2014-03-20

Donations after cardiac death kidney transplantation in northwest China

  • Online:2014-03-20 Published:2014-03-20

摘要: 目的探讨西北初期开展心脏死亡器官捐献(DCD)肾脏移植的效果及应对术后移植肾功能延迟恢复(DGF)的措施。方法
选自2011~2013年我院开展的DCD肾脏移植资料及术后随访记录,期间共有51例DCD供者家庭在ROC协调下知情并签字同
意器官捐献,通过OPO组织成功获取102只肾脏,实施了94例肾脏移植。术后根据是否发生DGF分为两组:DGF组和无DGF
组,并加以比较。结果DCD器官捐献的成功率是29.3%,DCD肾脏移植术后DGF发生率为27.7%,术后1年的人/肾成活率为
98.9%/95.7%。术后半年内DGF组eGFR值显著低于无DGF组,血清肌酐值显著高于无DGF组(P<0.05),移植半年后两组间无
显著性差异(P<0.05)。DGF发生率在应用LifePort低温机械灌注法保存的DCD供肾(21.5%)明显低于采用单纯低温冷保存的
供肾(41.4%,P<0.05)。结论尽管DCD肾脏移植术后DGF发生率偏高,但总体效果良好,推荐使用低温机械灌注法用于DCD
供肾的存储运输。

Abstract: Objective To explore the effect of donations after cardiac death (DCD) kidney transplant performed in northwest
China and the measures for management of delayed graft function (DGF). Methods In the period of 2011-2013, a total of 51
families of DCD donor gave their consent to organ donation by signing the informed consent with the help by a Red Cross
Organization (ROC) coordinater, and 102 kidneys were retrieved by organ procurement organization (OPO) teams.
Ninety-four operations of renal transplantation were carried out in our hospital. All the patients were followed-up and based
on the occurrence of DGF after transplantation, they were divided into DGF group and non-DGF group for comparative
studies. Results The success rate of donation after cardiac death was 29.3%, and the incidence of post-transplantation DGF was
27.7%. The 1-year human/kidney survival rate was 98.9%/95.7%. Within six months after the transplant, the values of eGFR in
DGF group were significantly lower and serum creatinine significantly higher than those in non-DGF group (P<0.05), but no
significant differences were found between the two groups thereafter (P>0.05). The occurrence of DGF in LifePort mechanical
perfusion cohorts was significantly lower than that in the simple cold preservation group (21.5% vs. 41.4% , P<0.05).
Conclusion The overall effect of DCD kidney transplant is good despite a high incidence of early DGF, and we recommend the
use of low-temperature mechanical perfusion for storage and transportation of DCD donor kidney.