胰肾联合移植八例早期疗效观察  

Early clinical observation of 8 cases of organ donation after death pancreas-kidney transplantation

作　　者：廖文尉 章诚[1] 何晓顺[1] 朱晓峰[1] 王文静[1] 胡安斌[1] 

机构地区：[1]中山大学附属第一医院器官移植科,广东省器官捐献与移植免疫重点实验室,广东省器官移植国家科技合作基地,广州510080

出　　处：《中华器官移植杂志》2016年第12期748-752,共5页Chinese Journal of Organ Transplantation

基　　金：国家自然科学基金（81371693、81172831）;广州市产学研协同创新重大专项（2060404）;广东省科技计划（20138010404016、20128031800257）;广东省自然科学基金（S2013010015935）

摘　　要：目的探讨器官捐献胰肾移植术后受者早期疗效。方法8例胰肾联合移植手术，受者均为糖尿病肾病患者。供者8例，其中男性6例，女性2例，供者年龄为（26±10）岁（15-42岁）。供者中4例为中国过渡时期脑-心双死亡器官捐献，3例为国际标准化脑死亡器官捐献，1例为国际标准化心死亡器官捐献。供、受者血型相同。结果8例受者均于术后4～6h清醒，8～14h撤除呼吸机；术后2～3d从外科重症监护病房转回普通病房开始正常康复治疗。术后血清C肽、胰岛素水平在1～2周内达正常范围，血糖在术后2～3周恢复正常；肌酐在术后1～2周内降至正常范围。其中，1例受者术中出现十二指肠肠壁血肿，遂切除移植胰腺，其余受者均于2周内恢复胰腺及肾脏功能。结论器官捐献胰肾联合移植术后器官早期功能恢复良好，在术前严格评估下，年轻供者捐献器官可安全用于胰肾联合移植。ObjectiveTo observe the early effect of organ donation after pancreas-kidney transplantation.MethodsEight cases of diabetic nephropathy received combined pancreas kidney transplantation. There were 8 donors, including 6 males and 2 females, with an average age of （26 10） years old （range from 15 to 42 years）. There were 4 cases of donors with China during the transition period of brain heart double death organ donation （C-Ⅲ） standard, 3 cases of donors in line with the international standard of brain death organ donation （C-Ⅰ） standard, 1 case of international standard of heart death organ donation （C-Ⅱ M-Ⅲ） citizen donors. There were 6 men and 2 women for recipients of the same blood type.ResultsEight cases were awake 4-6 h postoperation and the ventilator was removed 8-14 h after operation. The rehabilitation therapy began 2 days postoperation from surgery intensive care unit （SICU） to the common wards. Serum C-peptide and insulin levels achieved normal range in 1-2 weeks after transplant. Blood glucose returned to the normal level in 2-3 weeks, and the creatinine level decreased to the normal level in 2 weeks postoperation. Duodenal intramural hematoma occurred in one patient intraoperatively, and the pancreatic graft was removed for safe consideration. Other patients had no serious surgical complications within 2 weeks after transplantation.ConclusionFor organ donation after death of pancreas kidney transplantation, early organ function recovered well. Under the strict preoperative evaluation, the young donors can be safely used in combined pancreas and kidney transplantation.

关 键 词：供者选择 器官捐赠 糖尿病肾病 胰腺移植 肾移植 预后 

分 类 号：R657[医药卫生—外科学] R699[医药卫生—临床医学]