Salmeron-Rodriguez M D, Navarro-Cabello M D, Agüera-Morales M L, Lopez-Andreu M, Rodriguez-Benot A, Robles-Arista J C, Dueñas-Jurado J M, Campos-Hernandez J P, Requena-Tapia M J, Aljama-Garcia P
Department of Nephrology, Hospital Universitario Reina Sofía, Córdoba, Spain.
Department of Nephrology, Hospital Universitario Reina Sofía, Córdoba, Spain.
Transplant Proc. 2015 Jan-Feb;47(1):23-6. doi: 10.1016/j.transproceed.2014.11.012.
Kidney transplantation from donors after cardiac death (Type III Maastricht category) is a therapeutic option for patients with terminal renal failure.
We present a cohort of 8 patients who received a kidney transplant from donors after cardiac death (DCD). We analyzed the analytical results for the first 6 months after transplantation.
We included 8 cases of kidney transplants with organs from DCD (Type III Maastricht category). The mean age of donors was 58.40 ± 4.39 years and 3 (60%) were male. The mean creatinine (Cr) level prior to death was 1.10 ± 0.36 mg/dL. The mean age of recipients was 59.88 ± 10.58 years and 7 (87.5%) were male. Seven patients (87.5%) were on hemodialysis, whereas only 1 (12.5%) was on peritoneal dialysis. The median time on renal replacement therapy was 18 months (range, 2-76). Mean total warm ischemia time (WIT) was 24.88 ± 6.72 minutes, whereas the mean real WIT was 20.13 ± 4.51 minutes. The mean cold ischemia time (CIT) was 6 hours and 12 minutes ± 2 hours. Preimplantation biopsy showed acute tubular necrosis (extensive 40%). Tubular atrophy was mild in 100% of cases. After transplantation, 6 patients (75%) had delayed graft function requiring dialysis sessions whereas 2 patients (25%) did not require renal replacement therapy. Mean Cr level at 1, 3, and 6 months after transplantation was 2.37, 1.75, and 1.17 mg/dL, respectively.
Kidney transplantation with grafts from donors after cardiac arrest Maastricht Type III evolves favorably in the short term. According to preliminary results, controlled asystole donation could be an effective alternative to transplantation.
心脏死亡后供体肾移植（马斯特里赫特III类）是终末期肾衰竭患者的一种治疗选择。
我们报告了一组8例接受心脏死亡后供体（DCD）肾移植的患者。我们分析了移植后前6个月的分析结果。
我们纳入了8例接受DCD（马斯特里赫特III类）器官肾移植的病例。供体的平均年龄为58.40±4.39岁，3例（60%）为男性。死亡前的平均肌酐（Cr）水平为1.10±0.36mg/dL。受体的平均年龄为59.88±10.58岁，7例（87.5%）为男性。7例患者（87.5%）接受血液透析，而只有1例（12.5%）接受腹膜透析。肾替代治疗的中位时间为18个月（范围2 - 76个月）。平均总热缺血时间（WIT）为24.88±6.72分钟，而平均实际WIT为20.13±4.51分钟。平均冷缺血时间（CIT）为6小时12分钟±2小时。植入前活检显示急性肾小管坏死（广泛40%）。100%的病例肾小管萎缩轻微。移植后，6例患者（75%）出现移植肾功能延迟需要透析治疗，而2例患者（25%）不需要肾替代治疗。移植后1个月、3个月和6个月的平均Cr水平分别为2.37mg/dL、1.75mg/dL和1.17mg/dL。
马斯特里赫特III类心脏骤停后供体肾移植在短期内进展良好。根据初步结果，控制性心脏停搏供肾可能是移植的一种有效替代方案。
