成功移植终末期急性肾损伤供者的肾脏。
Successful transplantation of kidneys from deceased donors with terminal acute kidney injury.
机构信息
a Department of General and Transplantation Surgery , The Medical University of Warsaw , Warsaw , Poland.
b Department of Transplant Medicine, Nephrology and Internal Medicine , The Medical University of Warsaw , Warsaw , Poland.
出版信息
Ren Fail. 2019 Nov;41(1):167-174. doi: 10.1080/0886022X.2019.1590209.
BACKGROUND
There are many doubts with regards to accepting deceased kidneys with acute kidney injury (AKI) for transplantation.
PURPOSE
The aim of this study was to present the 5-years outcome of kidney transplantation cases where deceased donors developed AKI before organ procurement.
METHODS
Two hundred twenty-six deceased renal transplants were analyzed. Data regarding donors and recipients were collected. Terminal AKI was defined as terminal serum creatinine concentration higher than 1.99 mg/dL and 66 such cases were diagnosed. All kidney transplant recipients were followed for 60 months.
RESULTS
AKI group presented more episodes of delayed graft function (DGF) compared to the non-AKI group (56% vs 35%, p < .05). No differences were observed between the groups in the rate of acute rejection episodes, kidney function as well as patient and graft survival.
CONCLUSIONS
Transplants with AKI present more often DGF and comparable graft survival to transplants without AKI. Kidneys with AKI can be a valuable source of organs provided attentive selection and appropriate care of deceased donors.
背景
对于接受因急性肾损伤（AKI）而去世的供者的肾脏进行移植，存在许多疑问。
目的
本研究旨在介绍供者在器官获取前发生 AKI 的肾脏移植病例的 5 年结果。
方法
分析了 226 例已故的肾脏移植。收集了有关供者和受者的数据。终末期 AKI 的定义为终末期血清肌酐浓度高于 1.99mg/dL，共诊断出 66 例此类病例。所有接受肾脏移植的患者均随访 60 个月。
结果
与非 AKI 组相比，AKI 组更常出现延迟移植物功能（DGF）（56%比 35%，p<0.05）。两组之间急性排斥反应发作率、肾功能以及患者和移植物存活率均无差异。
结论
AKI 组的移植更常出现 DGF，但与无 AKI 组的移植物存活率相当。AKI 供肾可以成为有价值的器官来源，前提是对已故供者进行仔细选择和适当护理。
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