Analysis of early clinical efficacy of renal transplantation from extended criteria donor of the donation after cardiac death
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摘要:
目的 比较扩展标准供体(ECD)及标准供体(SCD)肾移植的早期临床效果。 方法 回顾性分析接受心脏死亡器官捐献(DCD)供肾肾移植的85例受体临床资料。根据供体类型,将相应受体分为ECD组(31例)和SCD组(54例)。比较两组受体肾移植术后3个月内血清肌酐(Scr)水平、早期并发症发生情况及预后情况。 结果 ECD组和SCD组术后1个月内的Scr水平差异无统计学意义(均为P > 0.05),ECD组术后60、90 d的Scr水平分别为(189±97)、(175±69)μmol/L,明显高于SCD组的(142±49)、(135±41)μmol/L(P=0.005,0.002)。ECD组和SCD组的急性排斥反应(AR)发生率分别为6%和15%,移植物功能延迟恢复(DGF)发生率分别为23%和19%,肺部感染发生率分别为10%和6%,其他早期并发症发生率分别为32%和15%,差异均无统计学意义(均为P > 0.05)。ECD组和SCD组人存活率分别为97%和94%,ECD组和SCD组肾存活率分别为84%和91%,差异均无统计学意义(均为P > 0.05)。 结论 与SCD相比,ECD肾移植亦可获得相当的早期临床效果。在目前供肾来源严重缺乏的条件下,ECD的使用可以扩大供肾来源。 -
关键词:
- 扩展标准供体(ECD) /
- 标准供体(SCD) /
- 心脏死亡器官捐献(DCD) /
- 肾移植 /
- 血清肌酐(Scr) /
- 急性排斥反应(AR) /
- 移植物功能延迟恢复 /
- 肺部感染
Abstract:Objective To compare the early clinical efficacy of renal transplantation between extended criteria donor (ECD) and standard criteria donor (SCD). Methods Clinical data of 85 recipients undergoing renal transplantation from donation after cardiac death (DCD) were retrospectively analyzed. According to the types of donors, all recipients were divided into the ECD group (n=31) and SCD group (n=54). The level of serum creatinine (Scr), incidence of early complications and clinical prognosis within 3 months after renal transplantation were compared between 2 groups. Results No statistical significance was observed in the levels of Scr within 1 month after renal transplantation between the ECD group and SCD group (all P > 0.05). At postoperative 60 and 90 d, the level of Scr in the ECD group was (189±97) and (175±69) μmol/L respectively, significantly higher than (142±49) and (135±41) μmol/L in the SCD group (P=0.005 and 0.002). In the ECD group and SCD group, the incidence of acute rejection (AR) was 6% and 15%, the incidence of delayed graft function (DGF) was 23% and 19%, the incidence of pulmonary infection was 10% and 6%, the incidence of other early complications was 32% and 15%, respectively, no statistical significance was identified (all P > 0.05). In the ECD group and SCD group, the survival rate of the recipient was 97% and 94%, the survival rate of the renal was 84% and 91%, no statistical significance was identified (all P > 0.05). Conclusions Compared with the SCD, renal transplantation from ECD can achieve equivalent early clinical efficacy. In the present condition of serious deficiency of donor kidney, the application of ECD can enlarge the supply of the donor kidney. -
表 1 两组受体肾移植术后早期并发症发生率的比较
Table 1. Comparison of the incidences of early complications in recipients between two groups after renal transplantation[n(%)]
组 别 n AR DGF 肺部感染 其他 ECD组 31 2(6)0 7(23) 3(10) 10(32) SCD组 54 8(15) 10(19). 3(6)0 08(15) χ2值 1.363 0.203 0.510 3.590 P值 0.238 0.652 0.476 0.057 其他并发症包括泌尿系感染、上呼吸道感染、移植肾周血肿、移植肾血栓、移植肾真菌感染、移植肾输尿管结石、髂外动脉假性动脉瘤、漏尿等 -
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