公民逝世后器官捐献合并AKI供体肾移植的疗效观察  

Therapeutic Effect of Organ Donation Combined with AKI Donor Kidney Transplantation after the Death of Citizens

作　　者：张建强[1] 蒋鹏[1] 顾新伟[1] 武桢[1] 高宏君[1] ZHANG Jian-qiang;JIANG Peng;GU Xin-wei;WU Zhen;GAO Hong-jun(Department of Urology,Ruikang Hospital,Guangxi University of Traditional Chinese Medicine,Nanning 531000,Guangxi,China)

机构地区：[1]广西中医药大学附属瑞康医院泌尿外科

出　　处：《医学信息》2019年第12期96-98,101,共4页Journal of Medical Information

基　　金：广西自然科学基金面上项目(编号:2017GXNSFAA198080)

摘　　要：目的探讨公民逝世后器官捐献(DCD)合并急性肾损伤(AKI)供体肾移植的临床疗效。方法回顾性分析2015年1月~2017年11月我院纳入的DCD42例,其中合并AKI供体13例,非AKI供体29例,比较两组供者、受者一般资料、两组受者术后指标及并发症发生率。结果本研究共13例AKI供体,其中标准供体7例,扩大标准供体6例;对照组29例非AKI供体,标准供体28例,扩大标准供体1例。两组供体年龄、性别、死亡原因、初始Scr及热缺血时间比较,差异无统计学意义(P>0.05);AKI组EDC供体占比、获取前Scr水平均高于对照组,差异有统计学意义(P<0.05)。AKI组中13例AKI供体行肾移植24例,对照组29例非AKI供体行肾移植56例。两组受者年龄、性别、体重指数、人类白细胞抗原错配数、群体反应性抗体>10%、冷缺血时间、灌注流量、灌注阻力指数比较,差异无统计学意义(P>0.05);AKI组肾脏机械灌注占比高与对照组,差异有统计学意义(P<0.05)。AKI组受者DGF发生率、DGF天数、住院时间,术后1周、1月Scr水平均高于对照组,差异有统计学意义(P<0.05);两组术后1年Scr水平、术后1年肾小球滤过率、术后1年移植肾存活率及术后1年患者存活率比较,差异无统计学意义(P>0.05)。AKI组并发症总发生率为37.50%,高于对照组的12.50%,差异有统计学意义(P<0.05)。结论DCD合并AKI的供体肾移植受者能获得较好的疗效,可作为扩大供体池的一种选择。Objective To investigate the clinical efficacy of organ donation (DCD) combined with acute kidney injury (AKI) donor kidney transplantation after the death of citizens. Methods A retrospective analysis of 42 cases of DCD included in our hospital from January 2015 to November 2017, including 13 cases of AKI donors and 29 cases of non-AKI donors, comparing the donors and recipients of the two groups, the two groups were Postoperative indicators and complication rates. Results A total of 13 AKI donors were included in the study, including 7 standard donors and 6 expanded standard donors;29 non-AKI donors in the control group, 28 standard donors, and 1 expanded standard donor. There were no significant differences in donor age, gender, cause of death, initial Scr and warm ischemia time between the two groups (P>0.05). The proportion of EDC donors in the AKI group and the Scr level before the acquisition were higher than the control group,the difference was statistically significant (P<0.05). In AKI group, 13 AKI donors underwent renal transplantation in 24 cases.56 renal transplantation was performed in 29 cases of non-AKI donors in the control group. There were no significant differences in age, gender, body mass index, human leukocyte antigen mismatch, population reactive antibody >10%, cold ischemia time, perfusion flow, and perfusion resistance index between the two groups (P>0.05). The renal mechanical perfusion ratio in the AKI group was higher than that in the control group,the difference was statistically significant (P<0.05). The incidence of DGF, the number of days of DGF, the length of hospital stay in AKI group, the level of Scr in 1 week and 1 month after operation were higher than those in the control group, the difference was statistically significant (P<0.05). The Scr level was 1 year after operation. There was no significant difference in the glomerular filtration rate, the survival rate of transplanted kidneys and the survival rate of patients after 1 year after operation in the first year (P>0.05).

关 键 词：急性肾损伤 肾移植 公民逝世后器官捐献 

分 类 号：R617[医药卫生—外科学]