LifePort在扩大标准供者肾脏的维护与评估中的作用  

Effects of LifePort on the preservation and evaluation of kidneys from extended criteria donors

作　　者：刘斌[1] 马智勇[1] 高宝山[1] 王淮林 徐世全[1] 周洪澜[1] 

机构地区：[1]吉林大学第一医院泌尿外二科,吉林长春130021

出　　处：《实用器官移植电子杂志》2017年第3期188-191,共4页Practical Journal of Organ Transplantation(Electronic Version)

基　　金：国家自然科学基金项目(81470975);吉林省科技项目(20130413029GH);吉林省卫生厅青年基金(2014Q021)

摘　　要：目的探讨低温持续机械灌注器(Life Port)在扩大标准供者(expanded criteria donors,ECD)肾脏的维护与评估中的作用及对移植预后的判断价值。方法回顾性分析吉林大学第一医院器官移植中心52例ECD肾脏应用LifePort进行低温持续机械灌注维护的参数指标及实施肾移植的临床资料,对供肾Life Port灌注情况及术后移植肾功能延迟恢复(delayed graft function,DGF)的发生率、排斥反应、血肌酐水平、1年人/肾存活率等情况进行总结和分析。结果 52例ECD供者成功捐献供肾104例,全部应用Life Port进行灌注维护,评估后弃用供肾8例,共完成96例肾移植,未出现移植肾原发性无功能(primary nonfunction,PNF);急性排斥反应(acute rejection,AR)的发生率为9.38%(9/96),经抗排斥反应治疗后均逆转;术后DGF的发生率为17.71%(17/96),患者均在1个月内恢复;与无DGF组受者相比,发生DGF受者的供肾灌注终末阻力平均值明显增高,差异有统计学意义(P<0.05);与无DGF组受者相比,发生DGF受者的供肾终末流速平均值显著降低,差异有统计学意义(P<0.05);随访6~42个月(中位时间为15个月),术后6个月平均血肌酐值为(113.7±38.4)μmol/L,1年的人/肾存活率均为100%。结论 LifePort在ECD肾脏维护及评估中具有重要作用,可以帮助决策是否使用供肾,结合灌注维护时参数可预估术后恢复情况。Objective To investigate the value of hypothermic continuous perfusion machine（LifePort） on the preservation and evaluation of grafts from expanded criteria donors（ECD） for renal transplantation and the value of the decision for transplantion prognosis. Methods The study included kidneys were procured from 52 ECDs underwent preserved with Life Port in First Hospital of Jilin University. The Life Port perfusion parameters and recipients＇ clinical data were analyzed retrospectively, such as delayed graft function（DGF） incidence, acute rejection rates, serum creatinine, 1-year patient and kidney allograft survival rates. Results Among 104 ECDs kidneys underwent preserved with Life Port, 8 kidneys were discarded after evaluation, and 96 kidneys were transplanted with no primary non-function（PNF）. The incidence of acute rejection（AR） was 9.38%（9/96）, all AR cases were recovered with anti-rejection treatment. The DGF incidence rate was 17.71%（17/96）, all DGF cases were recovered within one month. The average final resistance of the graft in patients who experienced DGF was significantly increased than that in patients with no DGF（P〈0.05）. Inversely, the average final flow rate of the graft in patients with DGF was significantly decreased than that in patients without DGF（P〈0.05）. The follow-up period was rangedfrom 6 to 42 months（the median time was 15 months）, the average serum creatinine of all recipients was（113.7± 38.4）μmol/L at 6-months follow-up, 1-year patient and kidney allograft survival rates were 100%. Conclusion Life Port played pivotal role in the preservation and evaluation of ECD grafts in renal transplants, combined with the Life Port perfusion parameters,the system gave assistance in any employ the graft or not, and predicted recipients＇ prognosis.

关 键 词：肾脏移植 扩大标准供肾 移植物功能延迟 

分 类 号：R699.2[医药卫生—泌尿科学]