中华器官移植杂志
中華器官移植雜誌
중화기관이식잡지
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
2011年
12期
709-711
,共3页
孟一曼%刘树荣%吴刚%李桂臣%陈旭春%杨蕾%李弘%李柏峰%王凤山%石蕊%程颖%金莹%刘永锋
孟一曼%劉樹榮%吳剛%李桂臣%陳旭春%楊蕾%李弘%李柏峰%王鳳山%石蕊%程穎%金瑩%劉永鋒
맹일만%류수영%오강%리계신%진욱춘%양뢰%리홍%리백봉%왕봉산%석예%정영%금형%류영봉
心脏死亡%组织供者%肾移植
心髒死亡%組織供者%腎移植
심장사망%조직공자%신이식
Cardiac death%Tissue donors%Kidney transplantation
目的 总结心脏死亡供者供肾的获取以及应用于临床肾移植的经验.方法 共7例心脏死亡供者捐献了供肾,进行了14例肾移植.7例供者年龄30～53岁,原发病为脑出血3例,颅脑外伤2例,脑基底动脉闭塞1例,颅脑肿瘤卒中1例;威斯康辛大学评分为19～23分,均为高危组.7例供者的所有近亲家属签署器官捐献知情同意的相关文件.临床评估供肾良好,供者心脏停跳2～5min后确定为心脏死亡,并采用腹腔多器官联合快速切取技术获取双侧肾脏.14例受者与供者HLA抗原错配数为2～4个,受者淋巴细胞毒交叉配合试验≤0.05,群体反应性抗体＜10％.7例供者中有6例的热缺血时间为5～10 min,1例为45 min;冷缺血时间为4.5～12.5 h.结果 利用心脏死亡供者供肾的14例肾移植手术均顺利完成.14例受者中,术后发生原发性移植肾无功能(PNF)1例,移植肾功能恢复延迟(DGF)3例,急性排斥反应2例;其中1例因PNF在术后第1天切除了移植肾,并恢复规律血液透析,1例因DGF仍在恢复中(尚处于术后3个月),血清肌酐149μmol/L,该2例受者均接受了热缺血时间为45 min的供肾;其余12例受者痊愈出院,移植肾功能均良好.结论 遵照《中国心脏死亡器官捐献指南》开展心脏死亡器官捐献工作,维护好潜在供者的各项重要生命指标,可以保证供肾质量;心脏死亡供者供肾可作为肾移植的重要器官来源,并且移植效果良好.
目的 總結心髒死亡供者供腎的穫取以及應用于臨床腎移植的經驗.方法 共7例心髒死亡供者捐獻瞭供腎,進行瞭14例腎移植.7例供者年齡30～53歲,原髮病為腦齣血3例,顱腦外傷2例,腦基底動脈閉塞1例,顱腦腫瘤卒中1例;威斯康辛大學評分為19～23分,均為高危組.7例供者的所有近親傢屬籤署器官捐獻知情同意的相關文件.臨床評估供腎良好,供者心髒停跳2～5min後確定為心髒死亡,併採用腹腔多器官聯閤快速切取技術穫取雙側腎髒.14例受者與供者HLA抗原錯配數為2～4箇,受者淋巴細胞毒交扠配閤試驗≤0.05,群體反應性抗體＜10％.7例供者中有6例的熱缺血時間為5～10 min,1例為45 min;冷缺血時間為4.5～12.5 h.結果 利用心髒死亡供者供腎的14例腎移植手術均順利完成.14例受者中,術後髮生原髮性移植腎無功能(PNF)1例,移植腎功能恢複延遲(DGF)3例,急性排斥反應2例;其中1例因PNF在術後第1天切除瞭移植腎,併恢複規律血液透析,1例因DGF仍在恢複中(尚處于術後3箇月),血清肌酐149μmol/L,該2例受者均接受瞭熱缺血時間為45 min的供腎;其餘12例受者痊愈齣院,移植腎功能均良好.結論 遵照《中國心髒死亡器官捐獻指南》開展心髒死亡器官捐獻工作,維護好潛在供者的各項重要生命指標,可以保證供腎質量;心髒死亡供者供腎可作為腎移植的重要器官來源,併且移植效果良好.
목적 총결심장사망공자공신적획취이급응용우림상신이식적경험.방법 공7례심장사망공자연헌료공신,진행료14례신이식.7례공자년령30～53세,원발병위뇌출혈3례,로뇌외상2례,뇌기저동맥폐새1례,로뇌종류졸중1례;위사강신대학평분위19～23분,균위고위조.7례공자적소유근친가속첨서기관연헌지정동의적상관문건.림상평고공신량호,공자심장정도2～5min후학정위심장사망,병채용복강다기관연합쾌속절취기술획취쌍측신장.14례수자여공자HLA항원착배수위2～4개,수자림파세포독교차배합시험≤0.05,군체반응성항체＜10％.7례공자중유6례적열결혈시간위5～10 min,1례위45 min;랭결혈시간위4.5～12.5 h.결과 이용심장사망공자공신적14례신이식수술균순리완성.14례수자중,술후발생원발성이식신무공능(PNF)1례,이식신공능회복연지(DGF)3례,급성배척반응2례;기중1례인PNF재술후제1천절제료이식신,병회복규률혈액투석,1례인DGF잉재회복중(상처우술후3개월),혈청기항149μmol/L,해2례수자균접수료열결혈시간위45 min적공신;기여12례수자전유출원,이식신공능균량호.결론 준조《중국심장사망기관연헌지남》개전심장사망기관연헌공작,유호호잠재공자적각항중요생명지표,가이보증공신질량;심장사망공자공신가작위신이식적중요기관래원,병차이식효과량호.
Objective To summarize the clinical experience of harvesting and using the kidneys from donation after cardiac death (DCD) donors.Methods Fourteen kidney transplantations were successfully performed on 14 patients with end-stage renal diseases.The kidneys were harvested from 7 volunteer donors (age 30～53 years) diagnosed with cardiac death,who were scored 19～23according to the University of Wisconsin donation after cardiac death evaluation.Primary diseases of the donors were cerebral hemorrhage,brain injury,ischemic cerebral vascular disease and brain tumor.Warm ischemia time ranged from 5 to 45 min,and cold ischemia time was 4.5 ～ 12.5 h.Results After transplantation,three patients had delayed graft function (DGF),one had primary non-function (PNF),and two patients developed acute rejection.In the patient with PNF,the transplanted kidney was removed one day after operation and the patient went back to hemodialysis.One patient with DGF was still in recovery with serum creatine 149 μmnol/L (within 3 months after operation).The above two cases both utilized the kidneys with 45 min of warm ischemia time.The rest 12 patients were discharged with normal renal function.Conclusion Under the condition of our country,kidneys strictly harvested from DCD donors can be used as one of the main sources of kidney grafts for kidney transplantation.
