供体亚低温状态对公民逝世后器官捐献移植肾功能的影响

Effect of hypothermia status in donors on renal graft function after renal transplantation from donation after citizen's death

目的探讨供体亚低温状态对公民逝世后器官捐献肾移植早期肾功能影响。方法将符合入选条件的36例公民逝世后器官捐献供体根据处理方式随机分为常温组(体温36.5~37.5℃,19例)和亚低温组(体温34.0~35.0℃,17例)。对应供体分组的肾移植受体包括常温组(38例)和亚低温组(34例)。比较两组供体、受体的围手术期情况和两组受体术后移植肾功能恢复情况,包括移植物功能延迟恢复(DGF)和原发性无功能(PNF)发生率。结果两组供体围手术期的尿量、血清肌酐(Scr)、收缩压、血氧饱和度、热缺血时间和冷缺血时间比较,均无统计学意义(均为P>0.05)。两组受体的手术时间、术中平均血糖、术中平均动脉压比较,差异均无统计学意义(均为P>0.05)。亚低温组和常温组受体术后DGF发生率分别为6%和24%,两组受体DGF发生率比较,差异有统计学意义(χ~2=4.393,P=0.036)。亚低温组和常温组受体术后PNF发生率均为3%,两组受体PNF发生率比较,差异无统计学意义(χ~2=0.000,P=1)。结论供体亚低温状态可以显著降低受体DGF的发生率,对PNF的发生率则无明显影响。

Objective To evaluate the effect ofhypothermia status in the donors upon the renal graft function after renal transplantation from donation after citizen＇s death. Methods Thirty-six eligible donors were randomly divided into the normal temperature （body temperature 36.5-37.5 ℃ , n=19） and hypothermia groups （body temperature 34.0-35.0℃ , n=17）. The matched recipients undergoing renal transplantation were also assigned into the normal temperature （n=38） and hypothermia groups （n=34）. Perioperative conditions of the donors and recipients were compared between two groups. And postoperative renal graft function of the recipients were statistically compared between two groups, including the incidence of delayed graft function （DGF） and primary nonfunction （PNF）. Results No statistical significance was identified in the perioperative amount of urine volume, serum creatinine （Scr）, systolic blood pressure, saturation oxygen, warm ischemia time and cold ischemia time of the donors between two groups （all P〉0.05）. No statistical significance was noted in terms of the operation time, intraoperative mean blood glucose and intraoperative mean arterial pressure of the recipients between two groups （all P〉0.05）. Postoperative incidence of DGF of the recipients in the hypothermia group was 6%, significantly lower than that in the normal temperature group （24%） X^2=4.393, P=0.036）. Postoperative incidence of PNF of the recipients was 3% in both the hypothermia and normal temperature groups with no statistical significance （X^2=0.000, P=1）. Conclusions The hypothermia status of the donors can significantly reduce the incidence of DGF, whereas exerts no evident effect upon the incidence of PNF in the recipients.