Department of Surgery, Chiba-East National Hospital, Chuo ku, Chiba City, Japan.
Cell Transplant. 2012;21(2-3):559-63. doi: 10.3727/096368911X605484.
Grafts from non-heart-beating donors (NHBDs) are used because of the limited availability of heart-beating brain-dead donors. These grafts sustain ischemic damage, and the severity of this damage varies among different areas of an organ. This study determined whether the results of islet isolation were correlated with the clinical outcomes of kidney transplantations in cases where both grafts were harvested from the same NHBD. Islets we isolated from the pancreata of 23 NHBDs between February 2004 and March 2007. Forty-six kidneys were also harvested from these NHBDs. The recipients of kidney transplants were divided into the successful isolation (n = 14) and failed isolation (n = 32) groups depending on the results of islet isolation. The clinical outcomes of kidney transplantation were compared between the recipients in these two groups. The immediate graft function rate and the 1-year graft survival rate after kidney transplantation in both groups were similar. Hemodialysis after transplantation was required for 6.0 days (SD, 5.2 days) in the successful isolation group and for 12.7 days (13.1 days) in the failed isolation group (p < 0.05). The serum creatinine concentrations at 1, 3, 6, and 12 months after transplantation were elevated in the failed isolation group (p < 0.05). The islet yield was inversely correlated with the requirement of hemodialysis (days) and the serum creatinine level at 1 month after transplantation. However, hemodialysis was required for only 7 days in the recipients of six kidneys that were obtained from NHBDs from whom <40,000 IEQ were obtained (extreme failure of islet isolation). The results of islet isolation were found to correlate with the kidney function after transplantation when both grafts are harvested from the same NHBD. However, the marginal conditions of NHBDs affect the results of islet isolation more than they do the posttransplantation kidney function.
从非心脏死亡供体（NHBD）获取的移植物是因为可用于心脏死亡脑死亡供体的数量有限。这些移植物受到缺血性损伤，损伤的严重程度在器官的不同区域有所不同。本研究旨在确定同种 NHBD 来源的供体中，胰岛分离的结果是否与肾移植的临床结果相关。从 2004 年 2 月至 2007 年 3 月期间的 23 名 NHBD 的胰腺中分离胰岛。从这些 NHBD 中还收获了 46 个肾脏。根据胰岛分离的结果，将接受肾移植的患者分为成功分离（n = 14）和分离失败（n = 32）组。比较两组患者肾移植的临床结果。两组患者的即刻移植物功能率和移植后 1 年移植物存活率相似。成功分离组移植后需要血液透析 6.0 天（SD，5.2 天），分离失败组需要血液透析 12.7 天（13.1 天）（p <0.05）。移植后 1、3、6 和 12 个月时，分离失败组的血清肌酐浓度升高（p <0.05）。胰岛产量与血液透析（天）的需求和移植后 1 个月时的血清肌酐水平呈负相关。然而，从胰岛分离极度失败（<40,000IEQ）的 NHBD 中获得的 6 个肾脏的受者仅需要血液透析 7 天。当从同种 NHBD 中获取两个移植物时，胰岛分离的结果与移植后肾功能相关。然而，NHBD 的边缘条件比移植后肾功能更能影响胰岛分离的结果。
