公民逝世后器官捐献供体综合评估及供肾功能维护  

Organ donors evaluation and function maintenance of donor kidney from organ donation after citizen’s death

作　　者：王锁刚[1] 翟琼瑶 卢鹏 迟凯凯[1] 王少朋 王光策[1] Wang Suogang;Zhai Qiongyao;Lu Peng;Chi Kaikai;Wang Shaopeng;Wang Guangce(Department of Urology and Kidney Transplantation,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450003,China)

机构地区：[1]河南中医药大学第一附属医院泌尿外肾移植科,郑州450003

出　　处：《国际移植与血液净化杂志》2020年第4期26-30,共5页International Journal of Transplantation and Hemopurification

基　　金：河南省重点研发与推广专项(科技攻关)(182102310247)。

摘　　要：目的:总结公民逝世后器官捐献(donation after citizens’decease,DCD)供体评估及供肾功能维护策略的实践经验。方法:回顾性研究58例DCD供体评估和筛选内容及供肾获取、灌注、保存、修整与肾移植手术过程,分析DCD供体的整体状况、供肾质量、肾功能的维护方案及肾移植效果。结果:58例DCD供者中,颅脑外伤和自发性脑出血是最常见的死亡原因。共获取供肾116个,其中1例捐献者的2个肾脏有感染病灶而弃用。供肾热缺血时间(5.6±1.2)min,冷缺血时间(6.5±1.6)h。非边缘性供肾(A级+B级)占93.1%,边缘性供肾(C级+D级)占6.9%,提示DCD供者质量总体良好。供肾获取、灌注、保存及肾移植过程顺利,肾移植总体效果理想。结论:对DCD供体的整体状态及重要脏器功能进行及时、准确、全面的评估,采取有效的供肾功能维护策略,保证供肾质量,有利于提高供肾的利用率,改善肾移植的临床效果。Objective:To summarize the practical experience of the strategy of donation after citizens’decease(DCD)donors evaluation and renal function maintenance.Methods:We analyzed the evaluation and screening contents of 58 DCD donors and the procedures of donor kidney acquisition,perfusion,preservation,repair and kidney transplantation retrospectively.Results:Craniocerebral trauma and spontaneous intracerebral hemorrhage were the most common causes of death in DCD donors.A total of 116 donor kidneys were obtained in 58 cases of DCD,of which 2 kidneys of 1 donor were abandoned due to infection.The hot ischemia time was(5.6±1.2)min and the cold ischemia time was(6.5±1.6)h.Non-marginal kidney donors(grade A+B)accounted for 93.1%,and marginal kidney donors(grade C+D)accounted for 6.9%,suggesting that the overall quality of DCD donors was good.The donor kidney was obtained,perfused,preserved and transplanted smoothly.The overall outcome of kidney transplantation was successful.Conclusions:Timely,accurate and comprehensive evaluation of the overall status and the function of important organs of DCD donors and effective maintenance of renal function are conducive to ensuring the quality of donor kidney,improving the utilization rate of donor kidney and improving the clinical effect of kidney transplantation.

关 键 词：公民逝世后器官捐献 供体评估 供肾维护 肾移植 

分 类 号：R193.3[医药卫生—卫生事业管理]