Na Ning, Li Ke, Huang Zhengyu, Miao Bin, Hu Cheng, Li Heng, Wang Dejuan, Qiu Jianguang
Department of Kidney Transplantation, The Third Affiliated Hospital of Sun Yat-Sen University.
Department of Urology, The Third Affiliated Hospital of Sun Yat-Sen University.
Transplant Direct. 2017 Jul 5;3(8):e189. doi: 10.1097/TXD.0000000000000704. eCollection 2017 Aug.
Donation after brain death followed by circulatory death (DBCD) is a new class in the unique Chinese donor classification system. Currently, in China, the organ transplantation of DBCD is rising. However, there is a dearth of research on the characteristics and outcomes of DBCD kidney transplantation.
We collected 128 DBCD renal transplant patients who underwent surgery between June 2013 and May 2016 at our center to analyze clinical outcomes and to share our experience to enhance perioperative management in DBCD kidney transplantation.
At the end of follow-up, no patients experienced primary nonfunction, but delayed graft function occurred in 25.8%. One- and 3-year graft survivals were 97.7% and 94.5%, respectively. The average length of stay was 20.88 ± 14.6 days, the incidence of posttransplant complications was 46.1% (59 patients), and 31 patients suffered more than 1 complication. In addition, the average length of stay of patients without complications and with at least 1 complication was 13.07 ± 2.01 days and 30.02 ± 17.4 days, respectively. There was a significantly higher incidence of complications associated with the postoperative hospital stay in DBCD patients.
Patients who received a DBCD kidney demonstrated a good outcome in terms of both graft survival and graft function. Hence, DBCD is suitable for national reality and conditions and offers a feasible option for deceased-donor kidney transplantation in China. To prevent complications and reduce the duration of hospital stay, we should strengthen preoperative and postoperative management.
脑死亡后循环死亡器官捐献(DBCD)是中国独特的供体分类系统中的一个新类别。目前,在中国,DBCD器官移植正在增加。然而,关于DBCD肾移植的特点和结果的研究却很匮乏。
我们收集了2013年6月至2016年5月在本中心接受手术的128例DBCD肾移植患者,以分析临床结果并分享我们的经验,以加强DBCD肾移植的围手术期管理。
随访结束时,没有患者发生原发性无功能,但25.8%的患者发生了移植肾功能延迟恢复。1年和3年移植肾存活率分别为97.7%和94.5%。平均住院时间为20.88±14.6天,移植后并发症发生率为46.1%(59例患者),31例患者发生了不止一种并发症。此外,无并发症和至少有一种并发症的患者平均住院时间分别为13.07±2.01天和30.02±17.4天。DBCD患者术后住院相关并发症的发生率明显更高。
接受DBCD肾移植的患者在移植肾存活和移植肾功能方面均表现出良好的结果。因此,DBCD适合中国国情,为中国尸体供肾移植提供了一种可行的选择。为预防并发症并缩短住院时间,我们应加强术前和术后管理。