急性肾损伤供肾用于肾移植的临床研究  

Clinical research of renal transplant from donation after citizen＆#39;s death （DCD） donor with acute kidney injury

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》2017年第3期131-135,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 探讨合并急性肾损伤（AKI）的公民逝世后器官捐献（DCD）供肾用于移植的临床应用效果.方法 回顾性分析西安交通大学第一附属医院2011年12月至2016年12月间312例DCD供者和相应622例受者肾移植的临床资料,根据供者是否发生AKI将移植受者分为AKI组和非AKI组,评估和比较两组的移植效果.结果 131例供者发生AKI,发生率为42.0％.AKI组和非AKI组受者术后移植肾器官功能恢复延迟（DGF）发生率分别为20.2％和7.2％（P＜0.01）,两组术后1个月血肌酐分别为（153.6±56.2）μmol/L和（119.3±40.7）μmol/L（P＜0.01）,相应的估算肾小球滤过率（eGFR）分别为（38.5±14.1）ml·min-1 ·1.73 m-2和（57.6±23.4） ml·min-1·1.73 m-2（P＜0.01）.移植1年后两组的血肌酐和eGFR的差异无统计学意义.结论 绝大部分合并AKI的DCD供肾可用于移植.尽管移植术后DGF的发生率较高,AKI供肾移植还是能够取得良好的移植效果.Objective To explore the clinical effect of renal transplant from donation after citizen＆#39;s death （DCD） donors with acute kidney injury （AKI）.Methods This was an observational retrospective study of 622 patients who underwent renal transplantation from 312 DCD donors＆#39; kidneys at the First Affiliated Hospital of Xi＆#39;an Jiaotong University from December 2011 to December 2016.The transplant patients were divided into AKI group and non-AKI group according to the Acute Kidney Injury Network （AKIN） criteria based on initial and terminal creatinine values.We evaluated and compared transplant outcomes of these two groups.Results There were 131 donors with AKI,and the incidence of AKI was 42.0 %.AKI group and non-AKI group recipients respectively had DGF in 20.2% and 7.2% of cases （P〈0.01）,153.6 ± 56.2 and 119.3 ± 40.7 μmol/L of serum creatinine （SCr） levels at 1st month （P〈0.01）,and 38.5 ± 14.1 and 57.6 ± 23.4 ml· min-1 （1.73 m2）-1 of eGFR at 1st month （P〈0.01）.There was no significant difference in SCr and eGFR between two groups at 1st year after transplantation.Conclusion Most of kidneys from DCD donors with AKI can be considered for transplantation.Renal transplantation of organs from DCD donors with AKI showed greater DGF but good outcomes.

关 键 词：急性肾损伤 器官捐献 肾移植 

分 类 号：R699.2[医药卫生—泌尿科学]