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使用心脏死亡后供体器官和脑死亡后供体器官进行肾移植的相似结果。

Similar Outcomes of Kidney Transplantations Using Organs From Donors After Cardiac Death and Donors After Brain Death.

作者信息

Nakamura Y, Kihara Y, Yokoyama T, Konno O, Iwamoto H

机构信息

Department of Kidney Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.

Department of Kidney Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.

出版信息

Transplant Proc. 2018 Oct;50(8):2404-2411. doi: 10.1016/j.transproceed.2018.03.088. Epub 2018 Mar 19.

Abstract

BACKGROUND

To increase the number of cadaveric kidney transplants in Japan, it is necessary to proactively use organs from all donors. Since the revision of the Organ Transplant Law, the number of organ donors after cardiac death (DCD) has decreased but the number of organ donors after brain death (DBD) has increased; however, the number of donor organs and awareness of cadaveric transplantation have increased.

METHODS

At our institution, 28 patients underwent cadaveric kidney transplantation from January 2001 to December 2016. These patients were classified into 2 groups according to DBD or DCD. Furthermore, 10 patients received transplants from expanded criteria donors (ECD) and 18 received them from standard criteria donors (SCD).

RESULTS

Kidney graft survival and engraftment were observed for all patients. There were no significant differences in renal function at 6 months for DBD and DCD transplant recipients. Renal function at 1, 3, and 5 years and serum creatinine levels were better for the ECD group. Renal function at 5 years after transplantation was significantly better for the SCD group than for the ECD group; however, there was no difference in delayed graft function between the SCD and ECD groups. Comparisons of the 3 groups showed good renal function for transplants from DBDs, but there was no significant difference in survival rates.

CONCLUSIONS

Results were good for all patients. There were no significant differences in outcomes of our patients who received transplants from ECD or SCD.

摘要

背景

为增加日本尸体肾移植的数量,有必要积极利用所有捐赠者的器官。自《器官移植法》修订以来,心脏死亡后器官捐赠者(DCD)的数量有所减少,但脑死亡后器官捐赠者(DBD)的数量有所增加;然而,捐赠器官的数量和尸体移植的认知度有所提高。

方法

在我们机构,2001年1月至2016年12月期间,28例患者接受了尸体肾移植。这些患者根据DBD或DCD分为两组。此外,10例患者接受了扩大标准供体(ECD)的移植,18例接受了标准标准供体(SCD)的移植。

结果

所有患者均观察到肾移植存活和植入情况。DBD和DCD移植受者6个月时的肾功能无显著差异。ECD组1年、3年和5年时的肾功能及血清肌酐水平更好。移植后5年时,SCD组的肾功能明显优于ECD组;然而,SCD组和ECD组之间的移植肾功能延迟无差异。三组比较显示,DBD供体移植的肾功能良好,但生存率无显著差异。

结论

所有患者的结果都很好。接受ECD或SCD移植的患者的结局无显著差异。

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