Goldsmith P J, Ridgway D M, Pine J K, Speak G, Newstead C, Lewington A J, Menon K V, Ahmad N, Attia M
Department of Organ Transplantation, St James’s University Hospital, Leeds, United Kingdom.
Transplant Proc. 2010 Dec;42(10):3963-5. doi: 10.1016/j.transproceed.2010.09.145.
With the increase of donation after cardiac death (DCD) now including procurements for not only kidney but also liver, pancreas, and lung transplantations, we analyze whether multiorgan DCD retrievals have a negative impact on immediate and short-term renal transplant outcomes due to increased length of time of explantation of the kidney from the donor and the associated risks of re-warming. We performed a retrospective study of all DCD donors from 2002 to 2009 at a single unit. Immediate and short-term outcomes between kidney-only versus multiorgan retrieval were compared. Cold ischaemia was significant between the two groups (P = .04), but all other variables were nonsignificant. The results show that immediate graft function, rates of acute rejection and graft/recipient survival are comparable when DCD allografts are procured from both multiorgan and kidney-only donors. The comparable outcomes from kidney-only and multiorgan donations in this study may be due to by the highly selective use of donors for multiorgan DCD donation. This selectivity may explain the "better" quality of kidney for these cases in which patients were able to tolerate potentially injurious rewarming.
随着心脏死亡后器官捐献（DCD）数量的增加，目前不仅包括肾脏，还包括肝脏、胰腺和肺移植的获取，我们分析多器官DCD获取是否会因供体肾脏取出时间延长及相关复温风险而对即刻和短期肾移植结果产生负面影响。我们对2002年至2009年在单个单位的所有DCD供体进行了一项回顾性研究。比较了仅获取肾脏与多器官获取之间的即刻和短期结果。两组之间冷缺血时间有显著差异（P = .04），但所有其他变量均无显著差异。结果表明，当从多器官供体和仅肾脏供体获取DCD同种异体移植物时，即刻移植肾功能、急性排斥反应发生率及移植物/受者生存率具有可比性。本研究中仅肾脏捐献和多器官捐献的结果相当，可能是由于多器官DCD捐献对供体的高度选择性使用。这种选择性可能解释了在这些患者能够耐受潜在有害复温的情况下肾脏“更好”的质量。
