Mohan P, Murphy D M, Counihan A, Cunningham P, Hickey D P
Department of Transplantation, Beaumont Hospital, Dublin, Ireland.
J Urol. 1999 Sep;162(3 Pt 1):682-4. doi: 10.1097/00005392-199909010-00012.
We analyze the effect of intraoperative heparin in cadaveric renal transplantation.
We examined the records of 100 consecutive cadaveric transplant recipients who received 5,000 units of heparin at the time of vascular clamping (group 1), and compared the incidence of graft thrombosis and postoperative hemorrhagic complications to 100 consecutive cadaveric transplant recipients who did not receive heparin (group 2). The groups were similar in terms of donor age, sex, number of transplant recipients, sensitization, multiple vessels, delayed graft function and human leukocyte antigen mismatch. All patients received cyclosporine based triple therapy immunosuppression. All explanted grafts were examined histologically to rule out hyperacute rejection.
There was no statistical difference between the 2 groups. The overall incidence of graft thrombosis was 5% (6% in group 1 and 4% in group 2). There was a greater need for blood transfusion in group 1, with 25 patients requiring transfusion postoperatively versus 14 in group 2.
Intraoperative heparin did not reduce the incidence of graft thrombosis in this retrospective study. It did increase the postoperative blood transfusion requirements. As a result of this analysis, we have abandoned its use.
我们分析术中使用肝素对尸体肾移植的影响。
我们检查了100例连续的尸体肾移植受者的记录，这些受者在血管钳夹时接受了5000单位肝素（第1组），并将移植物血栓形成和术后出血并发症的发生率与100例连续未接受肝素的尸体肾移植受者（第2组）进行比较。两组在供体年龄、性别、移植受者数量、致敏情况、多支血管、移植肾功能延迟和人类白细胞抗原错配方面相似。所有患者均接受基于环孢素的三联免疫抑制治疗。所有切除的移植物均进行组织学检查以排除超急性排斥反应。
两组之间无统计学差异。移植物血栓形成的总体发生率为5%（第1组为6%，第2组为4%）。第1组对输血的需求更大，25例患者术后需要输血，而第2组为14例。
在这项回顾性研究中，术中使用肝素并未降低移植物血栓形成的发生率。它确实增加了术后输血需求。基于此分析结果，我们已不再使用它。
