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脑死亡供体肾移植:中国的初步经验。

Kidney Transplantation From Brain-Dead Donors: Initial Experience in China.

作者信息

Li Y, Li J, Fu Q, Chen L, Fei J, Deng S, Qiu J, Chen G, Huang G, Wang C

机构信息

Department of Organ Transplantation, First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.

Department of Organ Transplantation, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.

出版信息

Transplant Proc. 2016 Oct;48(8):2592-2595. doi: 10.1016/j.transproceed.2016.07.027.

Abstract

BACKGROUND

Experience with kidney transplantation from brain-dead donors remains limited in China. Our objective was to evaluate the outcomes of kidney transplantation from brain-dead donors (group 1), compared with those from living ones of the same age (group 2).

METHODS

Clinical data of kidney transplantation from brain-dead donors and living donors in the same age range (18-45 years) performed between May 2007 and December 2011 were analyzed retrospectively. Recipients were analyzed for posttransplantation serum creatinine, creatinine clearance (calculated by the Cockcroft-Gault formula), the number of acute rejection episodes and delayed graft function, and patient/graft survival.

RESULTS

Mean donor age was comparable between the 2 groups (31.9 ± 6.5 vs 32.8 ± 7.0 years; P = .268). The terminal serum creatinine level of donors was 125.5 ± 63.5 μmol/L in group 1 (n = 30) and 65.1 ± 13.7 μmol/L in group 2 (n = 110; P = .000). Recipient creatinine clearance was comparable between the 2 groups 1 month posttransplantation and thereafter. Acute rejection episodes were seen in 7 cases in recipients of group 1 (15.9%) and in 15 cases in recipients of group 2 (13.6%; P = .716). The incidence of delayed graft function was higher in recipients of group 1 (18.2%) than that of group 2 (3.6%; P = .002). The 1-, 3-, and 5-year patient/graft survival rate was comparable between the 2 groups.

CONCLUSIONS

Our study demonstrated kidney transplantation from brain-dead donors achieved acceptable graft function and patient/graft survival in the 5-year follow-up, encouraging the use of this approach.

摘要

背景

在中国,脑死亡供体肾移植的经验仍然有限。我们的目的是评估脑死亡供体肾移植(第1组)与同年龄活体供体肾移植(第2组)的效果。

方法

回顾性分析2007年5月至2011年12月期间进行的年龄范围相同(18 - 45岁)的脑死亡供体和活体供体肾移植的临床数据。分析受者移植后的血清肌酐、肌酐清除率(采用Cockcroft - Gault公式计算)、急性排斥反应发作次数、移植肾功能延迟恢复情况以及患者/移植物存活率。

结果

两组供体的平均年龄相当(31.9 ± 6.5岁对32.8 ± 7.0岁;P = 0.268)。第1组(n = 30)供体的终末血清肌酐水平为125.5 ± 63.5 μmol/L,第2组(n = 110)为65.1 ± 13.7 μmol/L(P = 0.000)。移植后1个月及之后,两组受者的肌酐清除率相当。第1组受者中有7例(15.9%)发生急性排斥反应,第2组受者中有15例(13.6%)发生急性排斥反应(P = 0.716)。第1组受者移植肾功能延迟恢复的发生率(18.2%)高于第2组(3.6%;P = 0.002)。两组的1年、3年和5年患者/移植物存活率相当。

结论

我们的研究表明,在5年的随访中,脑死亡供体肾移植获得了可接受的移植肾功能以及患者/移植物存活率,这鼓励采用这种方法。

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