脑出血供者供肾移植临床效果分析  

Outcome of kidney transplantation with graft from intracerebral hemorrhage donors

作　　者：谭亮[1] 梁占锋 谢续标[1] 赵勇[2] 彭风华[1] 蓝恭斌[1] 余少杰[1] 王彧[1] 唐笑天[1] 宋磊[1] 刘锋[1] 方春华[1] 聂曼华[1] 郭勇[1] 谢东东 颜冲 彭龙开[1] Tan Liang;Liang Zhanfeng;Xie Xubiao;Zhao Yong;Peng Fenghua;Lan Gongbin;Yu Shaojie;Wang Yu;Tang Xiaotian;Song Lei;Liu Feng;Fang Chunhua;Nie Manhua;Guo Yong;Xie Dongdong;Yan Chong;Peng Longkai(Department of Urological Transplantation, Second Xiangya Hospital of Central South University, Changsha 410011,China;State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences,Beijing 100101,China)

机构地区：[1]中南大学湘雅二医院泌外器官移植科,长沙410011 [2]中国科学院动物研究所膜生物学国家重点实验室,北京100101

出　　处：《中华医学杂志》2019年第14期1106-1110,共5页National Medical Journal of China

摘　　要：目的分析中国公民逝世后器官捐献(CDCD)脑出血供者临床特点及脑出血供者供肾移植效果,为指导脑出血供肾捐献及移植提供依据。方法回顾性分析2013至2017年由中南大学湘雅二医院完成的脑出血供者(供者年龄≥10岁)与对应的初次单肾移植受体临床资料,以及2016年CDCD(供者年龄≥10岁)供肾移植受者随访资料。结果327例CDCD案例被纳入分析,脑出血供者数量及占比呈现逐年上升趋势,并在2017年达到全年CDCD案例的39.5%。脑出血供者的供肾丢弃率明显高于其他供者,但脑出血供者对延迟性恢复(DGF)的发生率并无影响。对2016年完成的145例CDCD供肾移植受者随访(22±4)个月,脑出血供者供肾移植的受者平均血肌酐水平高于其他供者供肾移植的受者,差异有统计学意义[(130±60)μmol/L比(111±38)μmol/L,P<0.05]。此外,通过比较估计肾小球滤过率(eGFR)发现脑出血供者供肾移植的受者eGFR低于其他供者供肾的受者,差异有统计学意义[(61±23)ml·min^-1·(1.73m^2)-1比(70±23)ml·min^-1·(1.73m^2)^-1,P<0.05]。结论CDCD脑出血供者数量及比例呈现逐年上升趋势,虽然脑出血供者供肾移植不会增加DGF发生率,但对长期肾移植效果可能是一个不利因素。Objective To analyze the data of kidney transplantation with allografts from intracerebral hemorrhage donors of China donation after citizen′s death (CDCD) and provide evidence to guide the clinical practice. Methods The clinical data of CDCD donors (age ≥10 years)and corresponding kidney allograft recipients, which were done by Second Xiangya Hospital of Central South University during January 1 2013 to December 31 2017, were analyzed retrospectively. Results 327 CDCD cases were analyzed, the number and percentage of intracerebral hemorrhage donors were gradually increasing and the percentage reached to 39.5% in 2017. The discarding rateof kidney allografts donated by intracerebral hemorrhage donors was higher than those donated by non-intracerebral hemorrhage donors, but intracerebral hemorrhage donor may not be a risk factor for DGF after the rigorous evaluation of kidney allografts. For 145 primary recipients transplanted in 2016 and had a 22±4 month follow-up, the recipients accepted the kidney from intracerebral hemorrhage donors had a higher level of serum creatinine[(130±60)μmol/L vs (111±38)μmol/L,P<0.05]and a lower eGFR[(61±23) ml·min-1·(1.73m2)-1 vs (70±23) ml·min-1·(1.73m2)-1,P<0.05] compared to the recipients accepted the kidney from non-intracerebral hemorrhage donors. Conclusion The number and percentage of organ donation from intracerebral hemorrhage donor is increasing, but the intracerebral hemorrhage donor may be a risk factor for long-term outcome of kidney transplantation.

关 键 词：脑出血 组织和器官获得 肾移植 

分 类 号：R699.2[医药卫生—泌尿科学]