摘要
目的探讨采用机械灌注保存心脏死亡器官捐献(DCD)供肾移植后移植肾功能延迟恢复(DGF)的发生及对早期移植物功能的影响。方法回顾性分析武汉大学中南医院2010年3月至2012年11月期间44例DCD供肾移植受者的临床资料,根据其供肾保存方式不同,分为机械灌注组(n=10)和静态冷储组(n=34例),比较两组受者DGF发生情况和早期移植物功能。结果两组供、受者一般资料具有可比性。术后1周,机械灌注组无受者发生功能性DGF,而静态冷储组功能性DGF发生率为32.4%(1/34),差别有统计学意义(χ2=6.68,P<0.05);机械灌注组DGF发生率为10%(1/10),静态冷储组DGF发生率为29.4%(10/34),差异无统计学意义(χ2=1.15,P>0.05)。机械灌注过程中肾动脉流量小于60mL/min和阻力系数大于0.5mmHg.mL-1.min-1时,受者发生DGF的概率明显增高。结论机械灌注能有效降低DCD供肾移植受者功能性DGF发生率,是临床维持和修复DCD供肾的重要方法;机械灌注阻力系数和流量可以作为临床评估DCD供肾质量的重要参数,也是判断预后的有益指标。
Objective To investigate the effects of machine perfusion(MP) on delayed graft function(DGF) and early functions of renal allografts from donation after cardiac death(DCD).Methods The clinical data of 44 patients who underwent DCD kidney transplantations in Zhongnan Hosiptal of Wuhan University from March 2010 to November 2012 were retrospectively analyzed.They were divided into MP group(n=10) and cold storage(CS) group(n=34) according to different ways of graft preservation.DGF and early functions of renal allografts were compared between the 2 groups.Results(1) Functional delayed graft function(f-DGF) occurred in 11 patients in the CS group(32.4%) and none was noted in the MP group(0),with a statistically significant difference(χ2=6.68,P〉0.05).DGF occurred in 1 patients in the MP group(10%),lower than that of the CS group(29.4%,10/34),but without a significant difference(χ2=1.15,P〉0.05).(2) During perfusion,kidneys with flows〉 60 mL/min and renal resistanc〈e0.50 seemed to have a higher risk of DGF after kidney transplantation.Conclusions MP preservation clearly reduced the risk of f-DGF.Flows and renal resistance may be key indicators in evaluating quality of DCD kidneys.
出处
《中华移植杂志(电子版)》
CAS
2013年第1期1-4,共4页
Chinese Journal of Transplantation(Electronic Edition)
基金
武汉市科技攻关项目(201161038344-01)
湖北省自然科学基金(2012FFA044)
武汉市科技局公共服务平台建设计划项目(2013060705010326)
关键词
心脏死亡器官捐献
肾移植
机械灌注
移植肾功能延迟恢复
阻力系数
Donation after cardiac death
Kidney transplantation
Machine perfusion
Delayed graft function
Renal resistance