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Lifeport与静态低温保存应用于器官捐献供肾保存效果的Meta分析

张驌 陈妍君 王诚 付生军 杨立

张驌, 陈妍君, 王诚, 等. Lifeport与静态低温保存应用于器官捐献供肾保存效果的Meta分析[J]. 器官移植, 2016, 7(4): 268-274. doi: 10.3969/j.issn.1674-7445.2016.04.004
引用本文: 张驌, 陈妍君, 王诚, 等. Lifeport与静态低温保存应用于器官捐献供肾保存效果的Meta分析[J]. 器官移植, 2016, 7(4): 268-274. doi: 10.3969/j.issn.1674-7445.2016.04.004
Zhang Su, Chen Yanjun, Wang Cheng, et al. Meta analysis of the effect of Lifeport and static cold storage on donor kidney[J]. ORGAN TRANSPLANTATION, 2016, 7(4): 268-274. doi: 10.3969/j.issn.1674-7445.2016.04.004
Citation: Zhang Su, Chen Yanjun, Wang Cheng, et al. Meta analysis of the effect of Lifeport and static cold storage on donor kidney[J]. ORGAN TRANSPLANTATION, 2016, 7(4): 268-274. doi: 10.3969/j.issn.1674-7445.2016.04.004

Lifeport与静态低温保存应用于器官捐献供肾保存效果的Meta分析

doi: 10.3969/j.issn.1674-7445.2016.04.004
基金项目: 

兰州大学第二医院引进人才科研专项基金 ynyjrckyzx2015-3-04

详细信息
    通讯作者:

    杨立,Email: yuze250@163.com

  • 中图分类号: R617,R195.1

Meta analysis of the effect of Lifeport and static cold storage on donor kidney

  • 摘要:   目的  系统评价Lifeport与静态低温保存(CS)在器官捐献供肾的保存效果。   方法  计算机检索Medline数据库、Embase数据库、考克兰图书馆(Cochrane library)、中国生物医学文献数据库、中国知网、万方数据库和维普数据库,搜集Lifeport与CS在移植肾保存效果的相关临床研究,检索时限均从建库至2015年12月31日。按照纳入与排除标准选择文献,评价质量并提取资料,并评价纳入研究的偏倚风险后,采用Stata 12软件进行Meta分析。   结果  共纳入16个研究,包括5个随机对照试验(RCT)和11个回顾性队列研究(RCS)。Meta分析结果显示:与CS组比较,(1) 总体捐献供肾(TDD),Lifeport组移植术后移植肾功能延迟恢复(DGF)发生率降低,DGF持续时间减少、平均住院日减少以及术后1年肾存活率增加,两组术后急性排斥反应(AR)发生率与1年人存活率相当;(2) 心脏死亡器官捐献供肾(DCD):Lifeport组术后DGF发生率降低,术后平均住院日减少,两组术后移植肾原发性无功能(PNF)与AR发生率,术后1年人、肾存活率比较,差异无统计学意义;(3) 扩展标准供肾(ECD):Lifeport组术后PNF发生率降低并改善术后1年肾存活率,两组术后DGF发生率、AR发生率与术后1年人存活率比较,差异无统计学意义。   结论  Lifeport应用于器官捐献供肾保存具有一定的优势,但受纳入研究数量及质量所限,上述研究结论尚需开展更多高质量研究予以验证。

     

  • 图  1  Lifeport组和CS组供肾术后DGF发生率的森林图

    Figure  1.  Forest plot of incidence of DGF between Lifeport group and CS group

    表  1  纳入16篇文献的基本情况

    Table  1.   Characteristics of 16 included studies

    研究作者 年份 国家/地区 研究类型 例数 供肾类型 研究指标
    Lifeport CS
    Moustafellos P,et al[7] 2007 英国 RCS 18 18 DCD ①④
    Plata-Munoz JJ,et al[8] 2008 英国 RCS 30 30 DCD ①③④⑤⑥⑦
    Moers C,et al[9] 2009 欧洲多中心 RCT 336 336 DCD/DBD ①②③④⑤⑥⑦
    Jochmans I,et al[10] 2010 欧洲多中心 RCT 82 82 DCD ①②③④⑤⑥⑦
    Watson CJ,et al[3] 2010 英国 RCT 45 45 DCD ①③④⑤⑥
    Abboud I,et al[11] 2011 法国 RCS 22 22 ECD ①③⑤⑥
    Treckmann J,et al[12] 2011 欧洲多中心 RCT 91 91 ECD ①②③⑤⑥⑦
    Gallinat A,et al[13] 2012 欧洲多中心 RCT 85 85 ECD ①②③⑤⑥⑦
    Sedigh A,et al[14] 2013 瑞典 RCS 36 59 DCD/DBD ①⑦
    Dion MS,et al[15] 2014 英国 RCS 15 15 DCD/DBD
    Guy A,et al[16] 2015 英国 RCS 74 101 DCD/DBD ①③
    钟自彪,等[17] 2013 中国 RCS 10 34 DCD ①④
    董建辉,等[18] 2014 中国 RCS 30 30 DCD ①④⑦
    项和立,等[19] 2014 中国 RCS 183 28 DCD
    王远涛,等[20] 2015 中国 RCS 146 42 DCD ①⑦
    袁小鹏,等[21] 2014 中国 RCS 35 35 DCD
    注:①DGF发生率;②DGF持续时间;③PNF发生率;④住院时间;⑤术后1年肾存活率;⑥术后1年人存活率;⑦AR发生率
    下载: 导出CSV
  • [1] 薛武军. 公民逝世后器官捐献供肾评估方法及改善的研究进展 [J]. 器官移植, 2015, 6(3): 131-133. http://www.organtranspl.com/browse/detail/qkid/72/id/73.html

    Xue WJ. Research progress on the evaluation methods and improvement of the kidney form donation after citizen's death[J]. Organ Transplant, 2015, 6(3): 131-133. http://www.organtranspl.com/browse/detail/qkid/72/id/73.html
    [2] 张驌, 付生军, 杨立. Lifeport在肾移植中的应用研究进展 [J]. 器官移植, 2015, 6(5): 298-302. http://www.organtranspl.com/browse/detail/qkid/88/id/122.html

    Zhang S, Fu SJ, Yang L. Research progress of Lifeport application in renal transplantation[J]. Organ Transplant, 2015, 6(5): 298-302. http://www.organtranspl.com/browse/detail/qkid/88/id/122.html
    [3] Watson CJ, Wells AC, Roberts RJ, et al. Cold machine perfusion versus static cold storage of kidneys donated after cardiac death: a UK multicenter randomized controlled trial [J]. Am J Transplant, 2010, 10(9): 1991-1999. doi: 10.1111/j.1600-6143.2010.03165.x
    [4] Matsuoka L, Shah T, Aswad S, et al. Pulsatile perfusion reduces the incidence of delayed graft function in expanded criteria donor kidney transplantation [J]. Am J Transplant, 2006, 6(6): 1473-1478. doi: 10.1111/ajt.2006.6.issue-6
    [5] 潘晓鸣,薛武军,刘林娟,等. 西北地区开展公民心脏死亡后捐献肾脏移植的报告[J].南方医科大学学报,2014,34(3):414-418,433. http://www.cnki.com.cn/Article/CJFDTOTAL-DYJD201403027.htm

    Pan X, Xue W, Liu L, et al. Donations after cardiac death kidney transplantation in northwest China [J]. J South Med Univ, 2014, 34(3): 414-418, 433. http://www.cnki.com.cn/Article/CJFDTOTAL-DYJD201403027.htm
    [6] 晏强, 韦晓莲, 李飞, 等. 机械灌注应用在肾移植中的效果评价( 附 36 例报道) [J]. 器官移植, 2014, 5(3): 182-185. http://www.cnki.com.cn/Article/CJFDTOTAL-QGYZ201403016.htm

    Yan Q, Wei XL, Li F, et al. Effect evaluation of mechanical perfusion in the application of renal transplantation:a report of 36 cases[J]. Organ Transplant, 2014, 5(3): 182-185. http://www.cnki.com.cn/Article/CJFDTOTAL-QGYZ201403016.htm
    [7] Moustafellos P, Hadjianastassiou V, Roy D, et al. The influence of pulsatile preservation in kidney transplantation from non-heart-beating donors [J]. Transplant Proc, 2007, 39(5): 1323-1325. doi: 10.1016/j.transproceed.2006.11.026
    [8] Plata-Munoz JJ, Muthusamy A, Quiroga I, et al. Impact of pulsatile perfusion on postoperative outcome of kidneys from controlled donors after cardiac death [J]. Transpl Int, 2008, 21(9): 899-907. doi: 10.1111/tri.2008.21.issue-9
    [9] Moers C, Smits JM, Maathuis MH, et al. Machine perfusion or cold storage in deceased-donor kidney transplantation [J]. N Engl J Med, 2009, 360(1): 7-19. doi: 10.1056/NEJMoa0802289
    [10] Jochmans I, Moers C, Smits J M, et al. Machine perfusion versus cold storage for the preservation of kidneys donated after cardiac death: a multicenter, randomized, controlled trial [J]. Ann Surg, 2010, 252(5): 756-764. doi: 10.1097/SLA.0b013e3181ffc256
    [11] Abboud I, Antoine C, Gaudez F, et al. Pulsatile perfusion preservation for expanded-criteria donors kidneys: impact on delayed graft function rate [J]. Int J Artif Organs, 2011, 34(6): 513-518. doi: 10.5301/IJAO.2011.8458
    [12] Treckmann J, Moers C, Smits JM, et al. Machine perfusion versus cold storage for preservation of kidneys from expanded criteria donors after brain death [J]. Transpl Int, 2011, 24(6): 548-554. doi: 10.1111/tri.2011.24.issue-6
    [13] Gallinat A, Moers C, Treckmann J, et al. Machine perfusion versus cold storage for the preservation of kidneys from donors ≥ 65 years allocated in the Eurotransplant Senior Programme [J]. Nephrol Dial Transplant, 2012, 27(12): 4458-4463. doi: 10.1093/ndt/gfs321
    [14] Sedigh A, Tufveson G, Bckman L, et al. Initial experience with hypothermic machine perfusion of kidneys from deceased donors in the Uppsala region in Sweden [J]. Transplant Proc, 2013, 45(3): 1168-1171. doi: 10.1016/j.transproceed.2012.10.017
    [15] Dion MS, McGregor TB, McAlister VC, et al. Hypothermic machine perfusion improves Doppler ultrasonography resistive indices and long-term allograft function after renal transplantation: a single-centre analysis [J]. BJU Int, 2014, 116(6):932-937 http://cn.bing.com/academic/profile?id=1946948198&encoded=0&v=paper_preview&mkt=zh-cn
    [16] Guy A, McGrogan D, Inston N, et al. Hypothermic machine perfusion permits extended cold ischemia times with improved early graft function [J]. Exp Clin Transplant, 2015, 13(2): 130-137. http://cn.bing.com/academic/profile?id=2474432700&encoded=0&v=paper_preview&mkt=zh-cn
    [17] 钟自彪, 叶啟发, 范林, 等. 应用机械灌注保存心脏死亡器官捐献供肾的效果分析 [J/CD]. 中华移植杂志(电子版), 2013, 7(1): 1-5.

    Zhong ZB, Ye QF, Fan L, et al. Effect of machine perfusion on preservation of kidneys from donors of cardiac death[J/CD]. Chin J Transplant(Electr Edit), 2013, 7(1): 1-5.
    [18] 董建辉, 廖吉祥, 孙煦勇, 等. LifePort保存心脏死亡器官捐献供肾的临床研究 [J]. 临床泌尿外科杂志, 2014, 29(8): 697-700. http://www.cnki.com.cn/Article/CJFDTOTAL-LCMW201408017.htm

    Dong JH, Liao JX, Sun XY, et al. Clinical research of transporting kidney from donation after cardiac death by LifePort[J].J Chin Urol, 2014, 29(8): 697-700. http://www.cnki.com.cn/Article/CJFDTOTAL-LCMW201408017.htm
    [19] 项和立, 薛武军, 田普训, 等. 公民逝世后器官捐献供者的评估与维护 [J]. 中华器官移植杂志, 2014, 35(7): 392-395. http://www.cnki.com.cn/Article/CJFDTOTAL-MNWK201602011.htm

    Xiang HL, Xue WJ, Tian PX, et al. Donor evaluation and maintenance of donation after citizens death[J]. Chin J Organ Transplant, 2014, 35(7): 392-395. http://www.cnki.com.cn/Article/CJFDTOTAL-MNWK201602011.htm
    [20] 王远涛, 王钢, 李红芹, 等. 肾脏灌注运输器在公民逝世后供者器官捐赠供肾移植中的应用 [J]. 中华器官移植杂志, 2015, 36(2): 78-81.

    Wang YT, Wang G, Li HQ, et al. Experience and effect of LifePort kidney transporter machines used in renal transplantation from donors after cardiac death[J]. Chin J Organ Transplant, 2015, 36(2): 78-81.
    [21] 袁小鹏, 周健, 陈传宝, 等. 心脏死亡器官捐献肾移植 101 例分析 [J/CD]. 中华移植杂志(电子版), 2014, 8(1): 4-8.

    Yuan XP, Zhou J, Chen CB, et al. Kidney transplantation from donation after cardiac death: a report of 101 cases[J/CD]. Chin J Transplant(Electr Edit), 2014, 8(1): 4-8.
    [22] Moers C, Pirenne J, Paul A, et al. Machine perfusion or cold storage in deceased-donor kidney transplantation [J]. N Engl J Med, 2012, 366(8): 770-771. doi: 10.1056/NEJMc1111038
    [23] Gallinat A, Moers C, Smits JM, et al. Machine perfusion versus static cold storage in expanded criteria donor kidney transplantation: 3-year follow-up data [J]. Transpl Int, 2013, 26(6): E52-E53. doi: 10.1111/tri.2013.26.issue-6
    [24] Chatauret N, Coudroy R, Delpech PO, et al. Mechanistic analysis of nonoxygenated hypothermic machine perfusion's protection on warm ischemic kidney uncovers greater eNOS phosphorylation and vasodilation [J]. Am J Transplant, 2014, 14(11): 2500-2514. doi: 10.1111/ajt.12904
    [25] Zhong Z, Du B, Wang R, et al. Hypothermic machine perfusion improves kidney viability through alleviation of vasospasm and edema of sertoli cell and renal tubular epithelial cell [J]. Transplantation, 2014, 98(S1):10.
    [26] Groen H, Moers C, Smits JM, et al. Cost-effectiveness of hypothermic machine preservation versus static cold storage in renal transplantation [J]. Am J Transplant, 2012, 12(7): 1824-1830. doi: 10.1111/j.1600-6143.2012.04030.x
    [27] O'Callaghan JM, Morgan RD, Knight SR, et al. Systematic review and Meta-analysis of hypothermic machine perfusion versus static cold storage of kidney allografts on transplant outcomes [J]. Br J Surg, 2013, 100(8): 991-1001. doi: 10.1002/bjs.9169
    [28] Lindell SL, Muir H, Brassil J, et al. Hypothermic machine perfusion preservation of the DCD kidney: machine effects [J]. J Transplant, 2013: 802618. http://cn.bing.com/academic/profile?id=2057474419&encoded=0&v=paper_preview&mkt=zh-cn
    [29] Wszola M, Kwiatkowski A, Diuwe P, et al. One-year results of a prospective, randomized trial comparing two machine perfusion devices used for kidney preservation [J]. Transpl Int, 2013, 26(11): 1088-1096. doi: 10.1111/tri.2013.26.issue-11
    [30] Lam VW, Laurence JM, Richardson AJ, et al. Hypothermic machine perfusion in deceased donor kidney transplantation: a systematic review [J]. J Surg Res, 2013, 180(1): 176-182. doi: 10.1016/j.jss.2012.10.055
    [31] Deng R, Gu G, Wang D, et al. Machine perfusion versus cold storage of kidneys derived from donation after cardiac death: a Meta-analysis [J]. PLoS One, 2013, 8(3): e56368. doi: 10.1371/journal.pone.0056368
    [32] Bathini V, McGregor T, McAlister VC, et al. Renal perfusion pump vs cold storage for donation after cardiac death kidneys: a systematic review [J]. J Urol, 2013, 189(6): 2214-2220. doi: 10.1016/j.juro.2012.11.173
    [33] Jiao B, Liu S, Liu H, et al. Hypothermic machine perfusion reduces delayed graft function and improves one-year graft survival of kidneys from expanded criteria donors: a Meta-analysis [J]. PLoS One, 2013, 8(12): e81826. doi: 10.1371/journal.pone.0081826
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出版历程
  • 收稿日期:  2016-03-10
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2016-07-15

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