低温机械灌注对老年供肾移植预后的改善作用  

Improvement effect of hypothermic machine perfusion on elder donor kidney transplantation

作　　者：张勤[1] 兰佳男[1] 徐艳[1] 何重香[1] 叶啟发[1,2] ZHANG Qin;LAN Jianan;XU Yan;HE Chongxiang;YE Qifa(Zhongnan Hospital of Wuhan University,Institute of Hepatobiliary Diseases of Wuhan University,Transplant Center of Wuhan University,&Hubei Key Laboratory of Medical Technology on Transplantation,Wuhan 430071,Hubei,China;The 3rd Xiangya Hospital of Central South University&Research Center of National Health Ministry on Transplantation Medicine Engineering and Technology,Changsha 410013,Hunan,China)

机构地区：[1]武汉大学中南医院/武汉大学肝胆疾病研究院/武汉大学医学移植中心/移植医学技术湖北省重点实验室,湖北武汉430071 [2]中南大学湘雅三医院/卫生部移植医学工程技术研究中心,湖南长沙410013

出　　处：《武汉大学学报（医学版）》2023年第10期1257-1261,共5页Medical Journal of Wuhan University

摘　　要：目的:探究低温机械灌注(HMP)系统对脑死亡器官捐献(DBD)老年供肾(年龄≥60岁)移植预后的改善作用。方法:武汉大学中南医院自2019年6月至2020年5月期间完成老年DBD供肾移植68例,随机分为两组,其中34例肾脏采用Lifeport低温机械灌注系统保存(HMP组),另外34例肾脏采用常规低温冷保存方式保存(SCS组)。比较两组患者肾移植术后移植肾功能延迟恢复(DGF)发生率、受者及移植物1年存活率、在院时间及血清肌酐水平等指标之间的差异。结果:两组受者在年龄、性别、冷缺血时间(CIT)等方面无显著差异。HMP组受者术后平均在院时间明显低于SCS组[HMP(16±7)d vs SCS(20±5)d,P=0.009]。DGF发生率HMP组低于SCS组,然而差异无统计学意义[HMP 8.82%(3/34)vs SCS 17.65%(6/34),P=0.476],受者1年生存率均为100%,移植物1年生存率HMP组高于SCS组,然而差异无统计学意义[HMP 100%(34/34)vs SCS 94.12%(32/34),P=0.493]。肾功能检测结果显示肾移植术后短期(0~7 d)及长期(7 d~12月)肌酐及尿素氮水平HMP组均低于SCS组。结论:与SCS相比,老年供肾应用HMP可明显改善早期移植物功能,然而远期疗效仍需进一步观察。Objective:To investigate the prognosis improvement effect of hypothermic machine perfusion(HMP)on elder(donor's age≥60 years)kidney transplantation from donation after brain death(DBD).Methods:The clinical data of 68 elder DBD kidneys of Zhongnan Hospital Wuhan University from June 2019 to May 2020 were analyzed.The kidneys were randomly divided into two groups ac⁃cording to the storage methods,static cold storage(SCS)and HMP,and there were 34 patients in each group.Hospitalization time,incidence of delayed graft function(DGF),1⁃year graft and recipient survival,and serum creatinine levels were analyzed between the two groups.Results:There were no significant differences in donor age,gender,and cold ischemic time between recipients of the two groups.As compared with SCS,HMP reduced the time of hospitalization significantly.Further⁃more,serum creatinine levels of HMP kidneys were lower than SCS kidneys during 0⁃7 days and 7 days⁃12 months after transplantation.What's more,HMP decreased DGF rate and increased graft sur⁃vival one year after transplantation,but the differences were not statistically significant.Conclusion:Compared with SCS,HMP can significantly improve the prognosis of elderly donor kidney transplan⁃tation.

关 键 词：公民逝世后器官捐献 肾移植 低温机械灌注 移植物功能延迟恢复 老年供肾 

分 类 号：R617[医药卫生—外科学]