摘要
目的探讨生理盐水替代组氨酸-色氨酸-酮戊二酸(histidine-tryptophan-ketoglurate,HTK)保存液对活体移植肾功能恢复的作用及可行性。方法亲属活体供肾肾移植的患者82例,按患者意愿分为生理盐水组(29例)和HTK组(53例)。生理盐水组用生理盐水作为移植肾灌注液,HTK组用HTK保存液作为移植肾灌注液。受者手术采用移植肾动、静脉分别与受者髂外动、静脉作端侧吻合。术后监测移植肾功能,包括记录循环开放后的泌尿初始时间、血清肌酐(Scr)降至177μmol/L所需时间,术后2、4、24周Scr水平,术后24h、48h、72h的尿量。同时观察术后的不良事件。结果两组受者的移植肾初始泌尿时间、Scr降至177μmol/L所需时间、术后24h、48h、72h的尿量比较差异均无统计学意义(均为P>0.05)。两组术后4周Scr水平相近,而术后2周和24周Scr水平比较差异有统计学意义,但均在正常范围值内。两组的移植物功能延迟恢复发生率与急性排斥反应发生率比较差异均无统计学意义(均为P>0.05)。结论在活体肾移植中,生理盐水替代HTK保存液作为器官保存液是可行的,对移植肾功能恢复有一定作用。
Objective To explore the feasibility of replacing histidine-tryptophan-ketoglurate （HTK） solution with normal saline in preserving living donor kidney grafts. Methods Eighty-two patients undergoing living-related donor renal transplantation were divided into normal saline group （ n = 29 ） and HTK group （ n = 53 ） according to patients＇ will. In normal saline group, normal saline was used as perfusion and preservation solution for transplant kidney, while HTK solution was used in HTK group. Reconstruction of renal circulation in recipients was made by end-to-side anastomosis of the renal vessels of donor and external iliae vessels of recipient. The renal function was monitored after transplantation, including initial urine output time, time for serum ereatinene （Set） declining to 177 μmol/L, the Scr levels at 2, 4, 24 weeks after transplantation and the urinary volume at 24 h, 48 h, 72 h after transplantation. The adverse events of transplant kidney were also observed after transplantation. Results There was no significant difference between the two groups in initial urine output time, time for Scr declining to 177 μmol/L and the urinary volume at 24 h, 48 h, 72 h after transplantation （ all in P 〉 0. 05 ）. There was also no significant difference between the two groups in Scr levels at 4 weeks after transplantation. Significant difference between two groups in Scr levels at 2 and 24 weeks was observed after transplantation, while the Scr levels were both in the normal range. There was no significant difference between two groups in the incidence rate of delayed graft function and acute rejection （ all in P 〉 0. 05 ）. Conclusion In living donor renal transplantation, it is feasible to replace HTK solution with normal saline as preservation solution and it is helpful for transplanted graft function recovery with normal saline.
出处
《器官移植》
CAS
2011年第5期269-272,共4页
Organ Transplantation
关键词
肾移植
活体供肾
器官保存液
生理盐水
组氨酸-色氨酸-酮戊二酸保存液
Renal transplantation
Living donor kidney
Organ preservation solution
Nornml saline
Histidine-tryptophan-ketoglurate solution
