改良肝肾联合切取法和整块尸肾摘取法对供肾质量的影响

Influence on Graft Function with Modified Method of Combined Liver and Kidney Procurement and Rapid En Bloc Kidney Procurement

目的比较改良肝肾联合切取法和整块尸肾摘取法对供肾质量的影响。方法收集本中心近年来有完整资料尸体供肾肾脏移植手术272例,其中整块法尸肾摘取供肾198个,改良肝肾联合切取法所获供肾74个。随访满12个月者共220例,其中整块法尸肾摘取供肾174个,改良肝肾联合切取获得供肾46个。结果整块法尸肾摘取组的平均取肾时间和肾静脉损伤发生率,优于改良肝肾联合切取组。而两者的1年人存活率,术后24 h、1周以及1年的肾功能无明显差异;改良肝肾联合切取法的1年肾存活率、1年排斥发生率及平均热缺血时间,均优于整块法尸肾摘取法。结论改良肝肾联合切取法的移植肾1年肾存活率和排斥发生率优于整块尸肾摘取法,但两种术式的1年人存活率和术后肾功能恢复无明显差别。

Objective To compare the graft function of 2 methods of kidney harvesting, the modified method of combined liver and kidney procurement and rapid en bloc kidney procurement. Methods The clinical data of 220 cadaveric renal transplantation recipients were collected （12 months follow-up） , 174 cases from en bloc kidney procurement and 46 from combined liver and kidney procurement. The average harvesting time, the incidence of renal vein injury, 1 year kidney survival and incidence of acute rejection were compared between the two methods. Results In average harvesting time and incidence of renal vein injury, the en bloc kidney procurement were better than the method of combined liver and kidney procurement. However, the method of combined liver and kidney procurement was better than the en bloc kidney procurement in 1 year kidney survival, 1 year incidence of acute rejection and average warm ischemia time. There was no difference in 1 year survival of patients and 24 h,1 week and 1 year graft function after transplantation. Conclusion Although the method of combined liver and kidney procurement is better than the en bloc kidney procurement in 1 year kidney survival and 1 year incidence of acute rejection, there is no difference between the 2 methods in 1 year survival of patients and graft function after transplantation.