器官捐献供者供肾逆行灌注早期经验  

Early experience with machine retrograde perfusion of deceased donor kidneys

作　　者：曾军 贾子豪 朱代文 宋涂润[1] 林涛[1] Zeng Jun;Jia Zihao;Zhu Daiwen;Song Turun;Lin Tao(Department of Urology,Institute of Urology,Organ transplantation center,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院泌尿外科,泌尿外科研究所,器官移植中心,成都610041

出　　处：《中华器官移植杂志》2021年第6期354-358,共5页Chinese Journal of Organ Transplantation

基　　金：国家自然科学基金面上项目(81870513)。

摘　　要：目的初步研究脑死亡供者供肾逆行机械灌注的安全性和有效性。方法本研究纳入四川大学华西医院2020年1月1日至2020年7月1日接受器官捐献供肾移植受者24例,所有的移植物都保存在脉冲灌注保存转运器(LifePort)中。按随机数字表法进行分组,其中12例采用逆行灌注的受者作为逆行灌注组,对应顺行灌注供肾移植受者作为顺行灌注组。比较两组受者术后肾功能、移植肾功能延迟事件发生率。结果对所有受者进行为期1个月的随访。逆行灌注组供肾灌注阻力指数在灌注过程中保持稳定。两组均无原发性移植肾无功能发生;两组移植肾功能延迟发生率差异无统计学意义(逆行灌注组3例,顺行灌注组2例,P=0.62);两组在术后30 d内的24 h尿量、血肌酐、估计肾小球滤过率、胱抑素C和血尿素氮均相似。逆行灌注组中阻力指数小于0.4的亚组肾功能在数值上优于阻力指数大于0.4的供肾,但差异无统计学意义。结论逆行灌注是一种安全有效的供肾机械灌注方法。Objective To explore the safety and efficacy of retrograde machine perfusion of kidneys from deceased donors.Methods From January 1,2020 to July 1,24 renal transplant recipients underwent organ donation.All grafts were preserved by Kidney Transporter machines(LifePort).Through a random number table,they were divided into two groups of retrograde perfusion(RP group,12 cases)and anterograde perfusion group(AP group,12cases).The incidence of delayed recovery of kidney/graft function was compared between two groups.Results During a follow-up period of 1 month,kidney resistance remained stable in RP group during perfusion.No primary non-function occurred in neither groups.No inter-group difference existed in the incidence of delayed graft function(3 in RP and 2 in AP,P=0.62).At all timepoints within 30 days,both groups had comparable values of urine output,serum creatinine,estimated glomerular filtration rate,cystatin c and blood urea nitrogen.RP group with a resistance index of<0.4 had numerically better kidney function than those with a resistance index of≥0.4.Conclusions This novel technique may be an effective and safe alternative for kidney preservation.

关 键 词：肾移植 逆行灌注 顺行灌注 

分 类 号：R699.2[医药卫生—泌尿科学]