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体外膜肺氧合对非可控型心脏死亡器官捐献供肾的保护作用

袁润强 宫满成 董文静 邓德成 龚朝阳

袁润强, 宫满成, 董文静, 等. 体外膜肺氧合对非可控型心脏死亡器官捐献供肾的保护作用[J]. 器官移植, 2018, 9(1): 74-78. doi: 10.3969/j.issn.1674-7445.2018.01.011
引用本文: 袁润强, 宫满成, 董文静, 等. 体外膜肺氧合对非可控型心脏死亡器官捐献供肾的保护作用[J]. 器官移植, 2018, 9(1): 74-78. doi: 10.3969/j.issn.1674-7445.2018.01.011
Yuan Runqiang, Gong Mancheng, Dong Wenjing, et al. Protective effect of extracorporeal membrane oxygenation on donor kidneys from non-controllable donation after cardiac death[J]. ORGAN TRANSPLANTATION, 2018, 9(1): 74-78. doi: 10.3969/j.issn.1674-7445.2018.01.011
Citation: Yuan Runqiang, Gong Mancheng, Dong Wenjing, et al. Protective effect of extracorporeal membrane oxygenation on donor kidneys from non-controllable donation after cardiac death[J]. ORGAN TRANSPLANTATION, 2018, 9(1): 74-78. doi: 10.3969/j.issn.1674-7445.2018.01.011

体外膜肺氧合对非可控型心脏死亡器官捐献供肾的保护作用

doi: 10.3969/j.issn.1674-7445.2018.01.011
基金项目: 

中山市科技计划重大项目 2016B1003

详细信息
    作者简介:

    袁润强,男,1971年生,博士,主任医师,研究方向为泌尿外科,Email: yuanrunqiang 2013@163.com

    通讯作者:

    宫满成,男,1983年生,博士,主治医师,研究方向为泌尿外科,Email: gongmancheng@163.com

  • 中图分类号: R617, R692

Protective effect of extracorporeal membrane oxygenation on donor kidneys from non-controllable donation after cardiac death

More Information
  • 摘要:   目的  探讨体外膜肺氧合(ECMO)对非可控型心脏死亡器官捐献(DCD)供肾的保护效果。  方法  随机选取60例非可控型DCD患者,按ECMO体内灌注的时间将60例供体随机分为3组,实验组1利用ECMO灌注2 h,实验组2灌注4 h,实验组3灌注6 h,每组20例,相应受体亦分为3组,每组20例。同时随机选取20例接受循环功能稳定的脑死亡器官捐献(DBD)的受体作为对照组。比较各组受体的移植物功能延迟恢复(DGF)、原发性移植物无功能(PNF)和急性排斥反应的发生率;比较各组受体的移植肾恢复时间、术后第1日尿量和术后1年移植肾功能等指标;比较各组受体术后1年人、肾存活率。  结果  与对照组比较,各实验组受体的PNF、DGF及急性排斥反应发生率的差异均无统计学意义(均为P>0.05)。与对照组比较,各实验组的移植肾功能恢复时间明显延长,差异有统计学意义(均为P < 0.05),而各实验组受体术后第1日尿量及术后1年的肾功能差异均无统计学意义(均为P>0.05)。各实验组及对照组肾移植术后1年的人、肾存活率均为100%,差异均无统计学意义(均为P>0.05)。  结论  利用ECMO技术辅助非可控型DCD的循环或呼吸功能可以很好地保护供肾功能,提高供肾使用率。

     

  • 表  1  各组受体术后早期并发症发生率的比较

    Table  1.   Comparison of the incidence of postoperative early complications among each group[n(%)]

    组别 n PNF DGF 急性排斥反应
    实验组1 20 0 1(5) 6(30)
    实验组2 20 0 3(15) 7(35)
    实验组3 20 1(5) 2(10) 5(25)
    对照组 20 0 2(10) 6(30)
    下载: 导出CSV

    表  2  各组受体术后移植肾功能恢复情况的比较

    Table  2.   Comparison of the early postoperative graft function among each group (x±s)

    组别 n 移植肾功能
    恢复正常时间(d)
    术后第1日
    尿量(mL)
    术后1年
    Scr(μmol/L)
    术后1年
    BUN(mmol/L)
    实验组1 20 9.7±2.3a 3 500±655 90±26 4.5±0.9
    实验组2 20 9.9±2.8a 3 450±700 109±29 5.2±1.1
    实验组3 20 9.7±2.2a 3 750±725 102±32 5.5±1.2
    对照组 20 7.1±2.9 3 650±670 98±30 5.6±1.2
      与对照组比较,aP < 0.05
    下载: 导出CSV
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出版历程
  • 收稿日期:  2017-10-11
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2018-01-15

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