CAJ | 학술논문

目的：比较中国Ⅰ类器官捐献即脑死亡器官捐献（ DBD）供肾与尸体供肾肾移植术后的早期临床效果。方法对34例DBD供肾受者和55例尸体供肾受者肾移植术后半年内的临床资料进行回顾性分析，通过比较两者术后第1、2周及1、3、6个月受者平均血清肌酐值，术后移植肾功能延迟恢复（ DGF）等并发症发生率，发生DGF后移植肾功能恢复时间等数据，对DBD供肾和尸体供肾的早期临床效果进行比较。结果 DBD供肾者术后1、2周血清肌酐值明显低于尸体供肾者（P＝0.000、0.014），1、3、6个月血清肌酐值与尸体供肾者相比差异无统计学意义（P＝0.397、0.345及0.194）。两者DGF发生率分别为11.8％和16.4％，差异无统计学意义（P＝0.773）， DBD供肾者术后发生DGF后移植肾功能恢复时间为（10.25±7.85）d，尸体供肾者为（28.56±13.56）d，两者差异有统计学意义（P＝0.031）。 DBD供肾者半年期间移植肾全部存活，尸体供肾者为（177.85±15.91）d，两者差异无统计学意义（P＝0.435），半年内两者受者均无死亡发生。 DBD供肾者围手术期内感染发生率为42.4％，明显高于尸体供肾者的18.2％（ P＝0.018）。结论 DBD供肾术后1、2周血清肌酐值明显低于尸体供肾，发生DGF后移植肾功能恢复较快，但围手术期感染发生率明显较高。
목적：비교중국Ⅰ류기관연헌즉뇌사망기관연헌（ DBD）공신여시체공신신이식술후적조기림상효과。방법대34례DBD공신수자화55례시체공신수자신이식술후반년내적림상자료진행회고성분석，통과비교량자술후제1、2주급1、3、6개월수자평균혈청기항치，술후이식신공능연지회복（ DGF）등병발증발생솔，발생DGF후이식신공능회복시간등수거，대DBD공신화시체공신적조기림상효과진행비교。결과 DBD공신자술후1、2주혈청기항치명현저우시체공신자（P＝0.000、0.014），1、3、6개월혈청기항치여시체공신자상비차이무통계학의의（P＝0.397、0.345급0.194）。량자DGF발생솔분별위11.8％화16.4％，차이무통계학의의（P＝0.773）， DBD공신자술후발생DGF후이식신공능회복시간위（10.25±7.85）d，시체공신자위（28.56±13.56）d，량자차이유통계학의의（P＝0.031）。 DBD공신자반년기간이식신전부존활，시체공신자위（177.85±15.91）d，량자차이무통계학의의（P＝0.435），반년내량자수자균무사망발생。 DBD공신자위수술기내감염발생솔위42.4％，명현고우시체공신자적18.2％（ P＝0.018）。결론 DBD공신술후1、2주혈청기항치명현저우시체공신，발생DGF후이식신공능회복교쾌，단위수술기감염발생솔명현교고。
Objective To compare the short -term clinical efficacy after kidney transplantation between from Chinese type Ⅰdonation and cadaveric donation .Methods We retrospectively analyzed the clinical outcomes within 6 months after kidney transplantation of 34 cases from donation after brain death ( DBD) and 55 from cadaveric kidney were retrospectively analyzed.The serum creatinine (Scr) 1, 2, 4, 12 and 24 weeks after transplantation were recorded , so were the occurrence of delayed graft function ( DGF) , complications , and recovery time of graft function after DGF .Re-sults The Scr levels were significantly lower in DBD group than in cadaveric donor group 1 and 2 weeks after transplanta-tion (P<0.05), but there was no significant difference 4, 12 or 24 weeks after transplantation (P>0.05).The inci-dence rates of DGF were 11.8%and 16.4%in DBD and cadaveric donor groups , respectively , with no significant differ-ence between these two groups ( P>0.05 ) .The recovery time of graft function after DGF in DBD and cadaveric donor groups were (10.25 ±7.85) and (28.56 ±13.56) d, respectively, with significant difference between them (P<0.05). Grafts were all survived within 6 months in DBD group, and survival time in cadaveric donor group was (177.85 ±15.91) d, but there was no significant difference between them (P>0.05).The incidence of perioperative infection was 42.4%in DBD group, which was significantly higher than 18.2%in cadaveric donor group (P<0.05).Conclusion Compare with traditional cadaveric donation , kidney transplantation from DBD donors shows favorable short -term recovery in term of graft function , and short duration of DGF recovery , but with higher incidence of perioperative infection .