机器灌注保存供肾在心脏死亡器官捐赠肾移植中的应用40例  

Application of machine perfusion preservation of kidneys in cardiac death donor kidney transplantation

作　　者：袁小鹏[1] 周健[1] 陈传宝[1] 韩明[1] 王小平[1] 焦兴元[1] 王长希[1] 何晓顺[1] 

机构地区：[1]中山大学附属第一医院东院器官移植三区,广州510700

出　　处：《中华器官移植杂志》2014年第5期273-276,共4页Chinese Journal of Organ Transplantation

基　　金：卫生部部属（管）医院临床学科重点项目（2010159）;卫生部公益性行业科研专项基金（201002004）;广东省科技计划临床医学重点项目（2011A030400005）

摘　　要：目的探讨机器低温脉冲灌注保存供肾在心脏死亡器官捐赠（DCD）肾移植中的应用。方法40例DCD供者，采用机器灌注保存一侧供肾（机器灌注组），另一侧常规静态低温保存供肾（冷储存组）。比较两组移植。肾功能延迟恢复（DGF）发生率和移植肾功能水平。结果8例供者因肾脏灌注阻力过高弃用供肾，肾脏灌注流量为（0．74±0．16）ml／sF（44．5±9．5）ml／min]，灌注阻力为（4．64±1．20）kPa·s^-1·ml^-1[（0．58±0．15）mmHg·ml^-1·min^-1]。32例供者的。肾脏用于移植，灌注流量为（1．54±0．55）ml／s[（92．4±32．9）ml／min]，肾脏灌注阻力为（2．56±1．04）kPa·S^-1·ml^-1[（0．32±0．13）mmHg·min^-1·ml^-1]。机器灌注组和冷储存组DGF发生率分别为15．6％和18．8％，差异无统计学意义（P〉0．05）。两组术后1个月、6个月和12个月估算的肾小球滤过率的差异均无统计学意义。结论采用机器灌注判断DCD供肾质量安全性良好，但是对于减少术后DGF和改善移植肾功能无明显作用。Objective To explore the effectiveness of machine hypothermic pulsatile perfusion preservation （PPP） for kidneys from donation after cardiac death （DCD） donors. Method One of the two kidneys from 40 DCD donors were pumped by LifePort Kidney Transporter （PPP group）, and another kidney was preserved by static cold-storage preservation （cold-storage group）. The incidence of delayed graft function （DGF） and renal graft function of two groups were analyzed. Result Sixteen kidneys from 8 donors were discarded, with flow of 44. 5 ± 9. 5 mL/min and resistances of 0. 58 ± 0. 15 mmHg/（mL/min）. Sixty-four kidneys from 32 donors were transplanted, with flow of 92. 4 ± 32. 9 mL/min and resistances of 0. 32 ± 0. 13 mmHg/（mL/min）. PPP group and cold-storage group showed similar incidence of I^F （15. 6% vs. 18. 8%, P〉 0. 05） and comparable estimated glomerular filtration rate at I st, 6th and 12th month after transplantation. Conclusion PPP is a useful method for viability testing for kidneys from DCD. But it seems that PPP can not decrease the incidence DGF or improve the renal graft function from DCD donors.

关 键 词：肾移植 器官保存 器官保存液 移植肾功能恢复延迟 

分 类 号：R699.2[医药卫生—泌尿科学]