Abboud Imad, Antoine Corinne, Gaudez François, Fieux Fabienne, Lefaucheur Carmen, Pillebout Evangéline, Viglietti Denis, Serrato Tomas, Vérine Jérôme, Flamant Martin, Peraldi Marie-Noëlle, Glotz Denis
Nephrology and Transplantation, Saint Louis Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
Int J Artif Organs. 2011 Jun;34(6):513-8. doi: 10.5301/IJAO.2011.8458.
Expanded criteria donors (ECD) kidneys are a potential solution to organ shortage, but exhibit more delayed graft function (DGF). We conducted a prospective controlled study aiming to evaluate the impact of pulsatile perfusion preservation (PPP) on DGF rate.
Inclusion criteria were: 1) ECD definition (any brain-dead donor aged > 60 years or aged 50-60 years with at least 2 of the following: history of hypertension, terminal serum creatinin level = 1.5 mg/dL, death resulting from a cerebrovascular accident; 2) Donor prolonged circulatory arrest (> 20 mn); 3) previsible cold ischemia time longer than 24 hours. In each pair of kidneys, one organ was preserved with PPP and the other organ was preserved in static cold storage.
From February 2007 to September 2009, a total of 22 donors (44 recipients) were included. Recipients were comparable in the two groups with respect to demographic and immunological data. The rate of DGF was significantly lower (9% vs. 31.8%, p = 0.021) in the PPP group. At 1, 3, and 12 months, renal function was comparable in the two groups.
Pulsatile perfusion preservation significantly reduced DGF rate in ECD kidney transplantation.
扩大标准供体（ECD）肾脏是解决器官短缺问题的一个潜在办法，但移植肾功能延迟恢复（DGF）更为常见。我们开展了一项前瞻性对照研究，旨在评估搏动灌注保存（PPP）对DGF发生率的影响。
纳入标准为：1）ECD定义（任何年龄>60岁的脑死亡供体，或年龄50 - 60岁且具备以下至少两项情况者：高血压病史、终末期血清肌酐水平 = 1.5 mg/dL、因脑血管意外死亡）；2）供体循环停止时间延长（>20分钟）；3）预计冷缺血时间超过24小时。在每对肾脏中，一个器官采用PPP保存，另一个器官采用静态冷藏保存。
从2007年2月至2009年9月，共纳入22例供体（44例受者）。两组受者在人口统计学和免疫学数据方面具有可比性。PPP组的DGF发生率显著更低（9%对31.8%，p = 0.021）。在1个月、3个月和12个月时，两组的肾功能相当。
搏动灌注保存显著降低了ECD肾脏移植中的DGF发生率。
