器官捐献影响移植肾功能恢复延迟的因素分析  

Analysis of factors influencing delayed graft function following kidney transplants from donation after citizens death

作　　者：高宝山[1] 王远涛[1] 王钢[1] 马智勇[1] 傅耀文[1] 周洪澜[1] 

机构地区：[1]吉林大学第一医院泌尿系统疾病诊治中心,长春130021

出　　处：《中华器官移植杂志》2017年第9期541-545,共5页Chinese Journal of Organ Transplantation

基　　金：吉林省科技发展计划项目（20160101100JC）;吉林省卫生计生青年基金（2015Q004）

摘　　要：目的探讨器官捐献影响移植肾功能恢复延迟的因素。方法回顾性分析吉林大学第一医院2011年8月至2017年5月间实施的504例公民逝世后器官捐献供肾移植的临床数据，分析术后早期移植肾功能恢复情况及可能影响移植肾功能的相关因素。结果504例肾移植中，围手术期出现移植肾功能恢复延迟（DGF）需透析辅助治疗者32例（6.3%）。术后发生DGF的恢复时间为（21.0±17.1）d。发生DGF者术前透析时间为（41.3±38.2）个月，较非DGF组患者透析时间（28.9±26.2）个月显著延长（P＝0.024）。DGF组供者的年龄为（42.7±9.4）岁，显著高于非DGF组供者的（39.0±15.9）岁（P＝0.009）。DGF组接受过心肺复苏的供者所占比例为21.9%，高于非DGF组接受过心肺复苏者所占比例（6.4%）（P＝0.001）。DGF组供者末次血肌酐为（149.3±98.3）μmol/L，显著高于非DGF组供者末次血肌酐水平（92.8±41.6）μmol/L（P〈0.001）。多因素分析发现，供者术前经历心肺复苏治疗、供者末次血肌酐水平以及受者体重指数均为影响DGF的独立危险因素（P＝0.001，P〈0.001，P＝0.008）。结论本研究通过对单中心公民逝世后器官捐献肾移植后影响DGF的因素进行分析，有利于发现并规避影响DGF的高危险因素，对于降低DGF的发生率，对于改善患者生存质量、降低医疗成本具有重要意义。ObjectiveTo investigate the factors influencing delayed graft function （DGF） following kidney transplants from donation after citizens death （DCD） in single transplant center.MethodsThe clinical data of 504 kidney transplants from DCD in the First Hospital of Jilin University between August, 2011 and May, 2017 were collected and analyzed retrospectively. The functional recovery of kidney graft and the related factors were analyzed, respectively.ResultsThe DGF occurred in 32 cases among 504 kidney transplant recipients during perioperative period, who received dialysis treatment （6.3%）. The average recovery time of DGF was 21.0±17.1 days. The average dialysis duration （41.3±38.2 months） pre-transplant in DGF group was significantly longer than that in non-DGF group （28.9±26.2 months） （P=0.024）. The average age of donors （42.7±9.4 years） in DGF group was significantly older than that in non-DGF group （39.0±15.9 years） （P=0.009）. The ratio of donors who received CPR treatment in DGF group （21.9%） was significantly higher than that in non-DGF group （6.4%） （P=0.001）. The average last serum creatinine level of donors in DGF group （149.3±98.3 mol/L） was significantly higher than that in non-DGF group （92.8±41.6 mol/L） （P〈0.001）. The multivariate analysis revealed that CPR treatment for donors before organ donation, the last serum creatinine level of donors as well as BMI of kidney transplant recipients were all independent risk factor influencing DGF （P=0.001, P〈0.001 and P=0.008, respectively）.ConclusionOur study focused on analysis of factors influencing DGF following kidney transplants from DCD in single transplant center. The results of this study are helpful to find and avoid the high risk factors that could influence DGF, reduce the incidence of DGF, improve the quality of patients’ life as well as reduce the cost of medical treatment.

关 键 词：肾移植 器官保护 移植物功能延迟 心脏死亡 

分 类 号：R699.2[医药卫生—泌尿科学]