机械灌注在公民逝世后器官捐献肾移植中的应用  

Clinical application of mechanical perfusion in donation after citizen＇ s death donor renal transplantation

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] 

机构地区：[1]西安交通大学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》2015年第6期330-334,共5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：目的探讨LifePort机械灌注在公民逝世后器官捐献（DCD）肾移植中的临床应用效果。方法回顾性分析西安交通大学第一附属医院2011年12月至2015年4月间183例DCD供肾移植的临床资料，其中145例DCD供肾采用LifePort机械灌注保存方法，286个供肾用于移植（机械灌注组）；28例DCD供肾采用单纯低温静态冷保存运输，其中54个供肾用于移植（单纯冷保存组）。供实施。肾移植340例，分析机械灌注对移植效果的影响。结果机械灌注组286个供肾用于移植，其供肾灌注时间为（2．9±1．6）h，灌注压为（26．9±8．7）mmHg（1mmHg=0．133kPa），灌注阻力系数为（0．24±0．17）mmHg·ml-1·min-1，灌注流量为（91．2±35．6）ml／min；4个供肾弃用，其灌注阻力系数为（0．62±0．27）mmHg·ml-1·min-1，灌注流量为（46．2±8．7）ml／min。共有45例受者术后发生肾功能恢复延迟（DGF），发生率为13．2％，其中机械灌注组DGF发生率为11．2％（32／286），单纯冷保存组发生率为24．1％（13／54），差异有统计学意义（P〈0．05）。机械灌注组血清肌酐恢复正常的时间为（4．8±1．5）d，单纯冷保存组血清肌酐恢复正常的时间为（8．7±2．6）d，机械灌注组移植肾功能恢复正常时间短于对照组（P〈0．05）。结论LifePort机械灌注保存对评估肾脏质量，降低肾脏灌注阻力，促进移植术后肾功恢复，减少D（并发生具有一定作用。Objective To explore the clinical effect of LifePort mechanical perfusion in donation after citizen＇s death （I）CD） donor renal transplantation. Method From December 2011 to April 2015, 183 cases of DCD and 340 cases of DCD donor renal transplantation were implemented in our transplant center. 145 DCD donors＂ kidneys were preserved by LifePort mechanical perfusion, 286 kidneys for transplantation; the 28 DCD donors＂ kidneys were preserved by static cold preservation, 54 kidneys for transplantation. Clinical data were analyzed retrospectively. Result 286 kidneys preserved by LifePort mechanical perfusion were transplanted, with perfusion time （2. 9 ±1.6） h, perfusion pressure （26. 9 ±8. 7） mmHg, resistance index （0. 24 ±0. 17） mmHg.ml-1 .min-1 , and perfusion flow （91.2 ± 35.6） ml/min. Four kidneys were discarded, with resistance index （0. 62 ± 0. 27） mmHg· ml-1·min-1, and perfusion flow （46. 2 ± 8. 7） ml/min. In 340 cases of renal transplant recipients, 45 cases developed renal delayed graft function （DGF）, with the incidence being 13.2%, meanwhile the incidence of DGF was 24. 1% （13/54） in recipients of donor kidneys preserved by static cold preservation and 11.2% （32/286） in recipients of donor kidneys preserved by LifePort~ mechanical perfusion （P^0. 05） respectively. The recovery time of renal function in recipients of donor kidney preserved by LifePort~ mechanical perfusion was significantly shorter than that in static cold preservation donor kidney recipients [（ 4. 8 ± 1.5 ） vs. （ 8. 7 ± 2. 6 ） days, P 〈 0. 05 ]. Conclusion The LifePort mechanical perfusion can evaluate donor kidney quality, promote the early recovery of transplant renal function and reduce the incidence of kidney transplant DGF.

关 键 词：肾移植 供者 机械灌注 

分 类 号：R699.2[医药卫生—泌尿科学]