中国Ⅰ类器官捐献供肾与尸体供肾的术后早期效果比较

Short- term efficacy comparison between from Chinese type Ⅰ donation and cadaveric donation for kidney transplantation

目的比较中国Ⅰ类器官捐献即脑死亡器官捐献(DBD)供肾与尸体供肾肾移植术后的早期临床效果。方法对34例DBD供肾受者和55例尸体供肾受者肾移植术后半年内的临床资料进行回顾性分析,通过比较两者术后第1、2周及1、3、6个月受者平均血清肌酐值,术后移植肾功能延迟恢复(DGF)等并发症发生率,发生DGF后移植肾功能恢复时间等数据,对DBD供肾和尸体供肾的早期临床效果进行比较。结果 DBD供肾者术后1、2周血清肌酐值明显低于尸体供肾者(P=0.000、0.014),1、3、6个月血清肌酐值与尸体供肾者相比差异无统计学意义(P=0.397、0.345及0.194)。两者DGF发生率分别为11.8%和16.4%,差异无统计学意义(P=0.773),DBD供肾者术后发生DGF后移植肾功能恢复时间为(10.25±7.85)d,尸体供肾者为(28.56±13.56)d,两者差异有统计学意义(P=0.031)。DBD供肾者半年期间移植肾全部存活,尸体供肾者为(177.85±15.91)d,两者差异无统计学意义(P=0.435),半年内两者受者均无死亡发生。DBD供肾者围手术期内感染发生率为42.4%,明显高于尸体供肾者的18.2%(P=0.018)。结论 DBD供肾术后1、2周血清肌酐值明显低于尸体供肾,发生DGF后移植肾功能恢复较快,但围手术期感染发生率明显较高。

Objective To compare the short -term clinical efficacy after kidney transplantation between from Chinese type I donation and cadaveric donation. Methods We retrospectively analyzed the clinical outcomes within 6 months after kidney transplantation of 34 cases from donation after brain death （DBD） and 55 from cadaveric kidney were retrospectively analyzed. The serum creatinine （Scr） 1, 2, 4, 12 and 24 weeks after transplantation were recorded, so were the occurrence of delayed graft function （DGF）, complications, and recovery time of graft function after DGF. Re- suits The Ser levels were significantly lower in DBD group than in cadaveric donor group 1 and 2 weeks after transplanta- tion （P 〈 0.05 ）, but there was no significant difference 4, 12 or 24 weeks after transplantation （ P 〉 0.05 ）. The inci- dence rates of DGF were 11.8% and 16.4% in DBD and cadaverie donor groups, respectively, with no significant differ- ence between these two groups （ P 〉 0. 05 ）. The recovery time of graft function after DGF in DBD and cadaverie donor groups were （ 10. 25 ±7. 85） and （28.56 ± 13.56） d, respectively, with significant difference between them （P 〈0. 05）. Grafts were all survived within 6 months in DBD group, and survival time in cadaveric donor group was （ 177. 85 ± 15.91 ） d, but there was no significant difference between them （ P 〉 0.05 ）. The incidence of perioperative infection was 42. 4% in DBD group, which was significantly higher than 18. 2% in cadaveric donor group （ P 〈 0.05 ）. Conclusion Compare with traditional eadaveric donation, kidney transplantation from DBD donors shows favorable short - term recovery in term of graft function, and short duration of DGF recovery, but with higher incidence of perioperative infection.