低温持续机械灌注系统在扩大标准供肾移植中早期效果分析  

Early effect of low temperature continuous mechanical perfusion system in expanding standard donor kidney transplantation

作　　者：陈鹏[1] 陈锐[1] 刘龙[1] 范连慧[1] 杨宏伟[1] 何龙[1] CHEN Peng,CHEN Rui,LIU Long,FAN Lian-hui,YANG Hong-wei,HE Long(Department of Urology,The General Hospital of Shenyang Military Command,Shenyang 110016,Chin)

机构地区：[1]沈阳军区总医院泌尿外科,辽宁沈阳110016

出　　处：《临床军医杂志》2018年第9期995-997,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨低温持续机械灌注系统(Life Port)在扩大标准供者(ECD)肾早期保存与评估中的作用。方法回顾性分析沈阳军区总医院泌尿外科自2014年4月至2018年3月完成的64例器官捐献ECD供肾资料及实施肾移植后受者的临床资料。其中,40例供肾应用Life Port低温机械灌注系统保存(Life Port组);24例供肾应用常规静态低温保存(常规组)。比较Life Port组、常规组的受者肾功能恢复情况、移植肾功能延迟恢复(DGF)的发生率、移植肾原发性无功能(PNF)发生率、急性排斥反应(AR)发生率。结果所有患者均顺利完成手术,术中无明显手术并发症。Lifeport组术后1、4、12周的血肌酐水平低于常规组,组间比较,差异有统计学意义(P <0. 05)。两组患者排斥反应均经抗排斥反应治疗后转为正常。Life Port组术后DGF发生率5. 0%(2/40),AR发生率5. 0%(2/40),无PNF发生。常规组术后DGF发生率25. 0%(6/24),AR发生率29. 2%(7/24),PNF发生率4. 2%(1/24)。两组DGF发生率、AR发生率比较,差异有统计学意义(P <0. 05)。结论低温机械灌注系统在肾移植ECD肾早期的维护及评估中具有重要作用,可降低术后DGF、AR等发生率,提高移植肾质量。Objective To investigate the role of low temperature continuous mechanical perfusion system（LifePort）in the early renal preservation and evaluation of expanded criteria donors（ECD）. Methods A retrospective study was performed on 64 cases of donor ECD donor kidney and the clinical data of recipients after renal transplantation from April 2014 to March 2018.There 40 cases were preserved by LifePort cryogenic mechanical perfusion system（LifePort group）and 24 cases of donor kidney were preserved by conventional static low temperature（conventional group）.The clinical data of renal function recovery in two groups and the incidence of delayed graft function（DGF）,the incidence of primary non-function（PNF）and the incidence of acute rejection（AR）were analyzed between the two groups.Results All the patients were successfully completed the operation without obvious surgical complications.The serum creatinine level of the LifePort group at 1,4 and 12 weeks after surgery was lower than that of the conventional group,and the difference was statistically significant（ P 〈0.05）.The rejection reaction of patients in both groups was normal after anti-rejection treatment.The incidence of postoperative DGF in LifePort group was 5.0%（2/40）and that of AR was 5.0%（2/40）without PNF.The incidence of postoperative DGF was 25.0%（6/24）,the incidence of AR was 29.2%（7/24）,and the incidence of PNF was 4.2% （1/24） in the conventional group.The incidence rates of DGF and AR were compared between the two groups,and the differences were statistically significant（ P 〈0.05）.Conclusion Low temperature mechanical perfusion system plays an important role in the early maintenance and evaluation of kidney transplantation ECD kidney,which can reduce the incidence of postoperative DGF or AR,and improve the quality of renal allograft.

关 键 词：肾移植 扩大标准供肾 低温机械灌注 

分 类 号：R699.2[医药卫生—泌尿科学]