摘要
目的探讨公民逝世后器官捐献(DCD)合并急性肾损伤(AKI)供体肾移植的临床疗效。方法回顾性分析2015年1月~2017年11月我院纳入的DCD42例,其中合并AKI供体13例,非AKI供体29例,比较两组供者、受者一般资料、两组受者术后指标及并发症发生率。结果本研究共13例AKI供体,其中标准供体7例,扩大标准供体6例;对照组29例非AKI供体,标准供体28例,扩大标准供体1例。两组供体年龄、性别、死亡原因、初始Scr及热缺血时间比较,差异无统计学意义(P>0.05);AKI组EDC供体占比、获取前Scr水平均高于对照组,差异有统计学意义(P<0.05)。AKI组中13例AKI供体行肾移植24例,对照组29例非AKI供体行肾移植56例。两组受者年龄、性别、体重指数、人类白细胞抗原错配数、群体反应性抗体>10%、冷缺血时间、灌注流量、灌注阻力指数比较,差异无统计学意义(P>0.05);AKI组肾脏机械灌注占比高与对照组,差异有统计学意义(P<0.05)。AKI组受者DGF发生率、DGF天数、住院时间,术后1周、1月Scr水平均高于对照组,差异有统计学意义(P<0.05);两组术后1年Scr水平、术后1年肾小球滤过率、术后1年移植肾存活率及术后1年患者存活率比较,差异无统计学意义(P>0.05)。AKI组并发症总发生率为37.50%,高于对照组的12.50%,差异有统计学意义(P<0.05)。结论DCD合并AKI的供体肾移植受者能获得较好的疗效,可作为扩大供体池的一种选择。
Objective To investigate the clinical efficacy of organ donation (DCD) combined with acute kidney injury (AKI) donor kidney transplantation after the death of citizens. Methods A retrospective analysis of 42 cases of DCD included in our hospital from January 2015 to November 2017, including 13 cases of AKI donors and 29 cases of non-AKI donors, comparing the donors and recipients of the two groups, the two groups were Postoperative indicators and complication rates. Results A total of 13 AKI donors were included in the study, including 7 standard donors and 6 expanded standard donors;29 non-AKI donors in the control group, 28 standard donors, and 1 expanded standard donor. There were no significant differences in donor age, gender, cause of death, initial Scr and warm ischemia time between the two groups (P>0.05). The proportion of EDC donors in the AKI group and the Scr level before the acquisition were higher than the control group,the difference was statistically significant (P<0.05). In AKI group, 13 AKI donors underwent renal transplantation in 24 cases.56 renal transplantation was performed in 29 cases of non-AKI donors in the control group. There were no significant differences in age, gender, body mass index, human leukocyte antigen mismatch, population reactive antibody >10%, cold ischemia time, perfusion flow, and perfusion resistance index between the two groups (P>0.05). The renal mechanical perfusion ratio in the AKI group was higher than that in the control group,the difference was statistically significant (P<0.05). The incidence of DGF, the number of days of DGF, the length of hospital stay in AKI group, the level of Scr in 1 week and 1 month after operation were higher than those in the control group, the difference was statistically significant (P<0.05). The Scr level was 1 year after operation. There was no significant difference in the glomerular filtration rate, the survival rate of transplanted kidneys and the survival rate of patients after 1 year after operation in the first year (P>0.05). The total incidence of complications in the AKI group was 37.50%, which was higher than that in the control group 12.50%,the difference was statistically significant (P<0.05). Conclusion DCD combined with AKI donor kidney transplant recipients can obtain better curative effect and can be used as an option to expand the donor pool.
作者
张建强
蒋鹏
顾新伟
武桢
高宏君
ZHANG Jian-qiang;JIANG Peng;GU Xin-wei;WU Zhen;GAO Hong-jun(Department of Urology,Ruikang Hospital,Guangxi University of Traditional Chinese Medicine,Nanning 531000,Guangxi,China)
出处
《医学信息》
2019年第12期96-98,101,共4页
Journal of Medical Information
基金
广西自然科学基金面上项目(编号:2017GXNSFAA198080)
关键词
急性肾损伤
肾移植
公民逝世后器官捐献
Acute kidney injury
Kidney transplantation
Organ donation after citizen's death
