解放军医学院学报
解放軍醫學院學報
해방군의학원학보
Academic Journal of Chinese Pla Medical School
2015年
5期
433-436,440
,共5页
李昆%钱叶勇%王振%柏宏伟%常京元%李钢%范宇
李昆%錢葉勇%王振%柏宏偉%常京元%李鋼%範宇
리곤%전협용%왕진%백굉위%상경원%리강%범우
肾移植%中国标准Ⅲ类心脏死亡器官捐献%预后%人/肾存活
腎移植%中國標準Ⅲ類心髒死亡器官捐獻%預後%人/腎存活
신이식%중국표준Ⅲ류심장사망기관연헌%예후%인/신존활
kidney transplantation%Chinese categoryⅢcardiac death donation%prognosis%patient/kidney survival
目的：探讨单中心开展心脏死亡器官捐献(donation after cardiac death，DCD)肾移植的临床效果。方法回顾性分析解放军第309医院2012年4月-2014年9月21例心脏死亡器官捐献肾移植供受者的随访资料。结果14例DCD供者中，因热缺血时间过长放弃2例，共捐献24个肾，21例于我院行单肾移植。受者随访1~28个月，其中术后移植肾原发性无功能(primary non-function，PNF)发生率为4.8%(1/21)；移植肾功能延迟恢复(delayed graft function，DGF)发生率为38.1%(8/21)；急性排斥反应(acute rejection，AR)发生率为19.1%(4/21)。移植肾切除2例(9.5%，2/21)，1例移植肾破裂切除，1例因PNF切除；余19例肾功能恢复正常；受者带功死亡2例(9.5%，2/21)，1例肺部感染死亡，1例因车祸死亡。术后6个月、12个月、18个月、24个月人/肾存活率分别为95.2%/85.7%、95.2%/85.7%、90.5%/80.9%、90.5%/80.9%。结论中国标准Ⅲ类DCD供体，移植受者具有较好的短期人/肾存活率，是缓解器官供体来源短缺的重要潜在方法。
目的：探討單中心開展心髒死亡器官捐獻(donation after cardiac death，DCD)腎移植的臨床效果。方法迴顧性分析解放軍第309醫院2012年4月-2014年9月21例心髒死亡器官捐獻腎移植供受者的隨訪資料。結果14例DCD供者中，因熱缺血時間過長放棄2例，共捐獻24箇腎，21例于我院行單腎移植。受者隨訪1~28箇月，其中術後移植腎原髮性無功能(primary non-function，PNF)髮生率為4.8%(1/21)；移植腎功能延遲恢複(delayed graft function，DGF)髮生率為38.1%(8/21)；急性排斥反應(acute rejection，AR)髮生率為19.1%(4/21)。移植腎切除2例(9.5%，2/21)，1例移植腎破裂切除，1例因PNF切除；餘19例腎功能恢複正常；受者帶功死亡2例(9.5%，2/21)，1例肺部感染死亡，1例因車禍死亡。術後6箇月、12箇月、18箇月、24箇月人/腎存活率分彆為95.2%/85.7%、95.2%/85.7%、90.5%/80.9%、90.5%/80.9%。結論中國標準Ⅲ類DCD供體，移植受者具有較好的短期人/腎存活率，是緩解器官供體來源短缺的重要潛在方法。
목적：탐토단중심개전심장사망기관연헌(donation after cardiac death，DCD)신이식적림상효과。방법회고성분석해방군제309의원2012년4월-2014년9월21례심장사망기관연헌신이식공수자적수방자료。결과14례DCD공자중，인열결혈시간과장방기2례，공연헌24개신，21례우아원행단신이식。수자수방1~28개월，기중술후이식신원발성무공능(primary non-function，PNF)발생솔위4.8%(1/21)；이식신공능연지회복(delayed graft function，DGF)발생솔위38.1%(8/21)；급성배척반응(acute rejection，AR)발생솔위19.1%(4/21)。이식신절제2례(9.5%，2/21)，1례이식신파렬절제，1례인PNF절제；여19례신공능회복정상；수자대공사망2례(9.5%，2/21)，1례폐부감염사망，1례인차화사망。술후6개월、12개월、18개월、24개월인/신존활솔분별위95.2%/85.7%、95.2%/85.7%、90.5%/80.9%、90.5%/80.9%。결론중국표준Ⅲ류DCD공체，이식수자구유교호적단기인/신존활솔，시완해기관공체래원단결적중요잠재방법。
Objective To explore the clinical effect of renal transplantation from donation after cardiac death (DCD) in single center. Methods Follow-up data about 21 cases with DCD renal transplantation in The 309th Hospital of Chinese PLA from April 2012 to September 2014 were retrospectively analyzed.Results Two of fourteen DCD donors were abandoned due to long warm ischaemia time, another 12 cases donated 24 kidneys and 21 cases underwent single kidney transplantation in our hospital. DCD recipients were followed up for 1 to 28 months. Of the 21 cases, primary non-function (PNF) only occurred in one case (4.8%) and delayed graft function (DGF) in 8 (38.1%) recipients, acute rejection (AR) in 4 (19.1%) recipients. Two (9.5%) recipients lost their graft. One case had nephrectomy due to the rupture of graft and one case had nephrectomy due to PNF. Nineteen recipients recovered to normal renal function. But two (9.5%) recipients died with normal renal function, of which, one was acute pneumonia and one was traffic accident. The actuarial survival rates of recipients and graftsat 6, 12, 18, 24 months after renal transplantation were 95.2%, 95.2%, 90.5%, 90.5%, and 85.7%, 85.7%, 80.9%, 80.9%, respectively.Conclusion Chinese categoryⅢ cardiac death transplant recipients have good short term patient/kidney survival rate and is a potential method to relieve the shortage of donative organs.
