公民逝世后器官捐献供者的评估与维护  

Donor evaluation and maintenance of donation after citizens death

作　　者：项和立[1] 薛武军[1] 田普训[1] 丁小明[1] 潘晓鸣[1] 燕航[1] 侯军[1] 冯新顺[1] 刘林娟[1] 

机构地区：[1]西安交通大学医学院第一附属医院肾脏病医院肾移植科,710061

出　　处：《中华器官移植杂志》2014年第7期392-395,共4页Chinese Journal of Organ Transplantation

基　　金：卫生部卫生公益性行业科研专项基金（201002004）

摘　　要：目的 总结公民逝世后器官捐献（DCD）供者评估和维护的经验.方法 回顾性分析2011年12月至2014年4月间共实施的112例DCD器官捐献和211例DCD供肾移植的临床资料.对供者的评估和维护及移植效果进行分析.结果 实施112例DCD中,中国三类98例,中国二类14例.获取肾脏222个,实施肾移植211例.急性排斥反应发生率7.1％（115/211）,移植肾功能恢复延迟（DGF）发生率11.4％（24/211）.接受原发病为脑血管意外供者供肾移植的受者术后1和6个月的估算肾小球滤过率（eGFR）显著低于接受其他原发病供者供肾移植的受者（P＜0.01）.器官获取前无低血压和未行心肺复苏供者的eGFR显著高于有低血压和进行过心肺复苏的供者（P＜0.01））,且前者相应受者的移植后eGFR更高（P＜0.05）.应用LifePort（R）机械灌注后DGF发生率显著降低（P＜0.05）.结论 早期正确的DCD供者的评估和维护能够获得更高质量的移植器官和更好的移植效果.Objective To summarize the experience of donor evaluation and maintenance of donation after citizens death （DCD）.Method A retrospective analysis on the clinical data of 112 cases of DCD and 211 cases of DCD donor renal transplantation was done from December 2011 to April 2014.Donor evaluation and maintenance was performed as early as possible Result 112 DCD cases were performed,including 14 cases of C-Ⅱ and 98 cases of C-Ⅲ.222 donated kidneys were harvested,211 kidneys for transplantations.Among 211 cases of renal transplant recipients,the incidence of acute rejection （AR） was 7.1 ％ （15/211）,and that of postoperative renal delayed graft function （DGF） was 11.4％ （24/211）.The recipient estimated glomerular filtration rate （eGFR） at 1st and 6th month after cadaver renal transplantation from donors by cerebrovascular accident was lower than that by all other causes （P ＜ 0.01）.The donor eGFR was lower in donors with hypotension and cardio-pulmonary resuscitation （P＜0.01）,and the recipient eGFR was lower in the recipients from donors with hypotension and cardio-pulmonary resuscitation （P ＜ 0.05）.DGF incidence of using LifePort（R） was lower than that of not using LifePort（R） significantly （P＜0.05）.Conclusion Early and correct evaluation and maintenance of the potential organ donor allows better quality of donated organs and transplant outcomes.

关 键 词：公民逝世后器官捐献 供者 评估 维护 肾移植 

分 类 号：R193.3[医药卫生—卫生事业管理]