中国标准Ⅲ类心脏死亡供者肾移植21例临床分析  

Renal transplantation from Chinese category Ⅲ cardiac death donors: A clinical analysis of 21 cases

作　　者：李昆 钱叶勇[2] 王振[2] 柏宏伟[2] 常京元[2] 李钢[2] 范宇[2] 

机构地区：[1]解放军医学院,北京100853 [2]解放军第309医院全军器官移植研究所泌尿二科,北京100091

出　　处：《解放军医学院学报》2015年第5期433-436,440,共5页Academic Journal of Chinese PLA Medical School

基　　金：首都临床特色应用研究(Z131107002213139)~~

摘　　要：目的探讨单中心开展心脏死亡器官捐献（donation after cardiac death,DCD）肾移植的临床效果。方法回顾性分析解放军第309医院2012年4月-2014年9月21例心脏死亡器官捐献肾移植供受者的随访资料。结果 14例DCD供者中,因热缺血时间过长放弃2例,共捐献24个肾,21例于我院行单肾移植。受者随访1~28个月,其中术后移植肾原发性无功能（primary non-function,PNF）发生率为4.8%（1/21）;移植肾功能延迟恢复（delayed graft function,DGF）发生率为38.1%（8/21）;急性排斥反应（acute rejection,AR）发生率为19.1%（4/21）。移植肾切除2例（9.5%,2/21）,1例移植肾破裂切除,1例因PNF切除;余19例肾功能恢复正常;受者带功死亡2例（9.5%,2/21）,1例肺部感染死亡,1例因车祸死亡。术后6个月、12个月、18个月、24个月人/肾存活率分别为95.2%/85.7%、95.2%/85.7%、90.5%/80.9%、90.5%/80.9%。结论中国标准Ⅲ类DCD供体,移植受者具有较好的短期人/肾存活率,是缓解器官供体来源短缺的重要潜在方法。Objective To explore the clinical effect of renal transplantation from donation after cardiac death （DCD） in single center. Methods Follow-up data about 21 cases with DCD renal transplantation in The 309th Hospital of Chinese PLA from April 2012 to September 2014 were retrospectively analyzed.Results Two of fourteen DCD donors were abandoned due to long warm ischaemia time, another 12 cases donated 24 kidneys and 21 cases underwent single kidney transplantation in our hospital. DCD recipients were followed up for 1 to 28 months. Of the 21 cases, primary non-function （PNF） only occurred in one case （4.8%） and delayed graft function （DGF） in 8 （38.1%） recipients, acute rejection （AR） in 4 （19.1%） recipients. Two （9.5%） recipients lost their graft. One case had nephrectomy due to the rupture of graft and one case had nephrectomy due to PNF. Nineteen recipients recovered to normal renal function. But two （9.5%） recipients died with normal renal function, of which, one was acute pneumonia and one was traffic accident. The actuarial survival rates of recipients and graftsat 6, 12, 18, 24 months after renal transplantation were 95.2%, 95.2%, 90.5%, 90.5%, and 85.7%, 85.7%, 80.9%, 80.9%, respectively.Conclusion Chinese categoryⅢ cardiac death transplant recipients have good short term patient/kidney survival rate and is a potential method to relieve the shortage of donative organs.

关 键 词：肾移植 中国标准Ⅲ类心脏死亡器官捐献 预后 人/肾存活 

分 类 号：R699.2[医药卫生—泌尿科学]