Tomita Yusuke, Iwadoh Kazuhiro, Hoshino Akiko, Ogawa Yuichi, Sannomiya Akihito, Nakajima Ichiro, Fuchinoue Shohei
Department of Surgery, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
Department of Surgery, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
Transplant Proc. 2019 Oct;51(8):2523-2526. doi: 10.1016/j.transproceed.2019.01.201. Epub 2019 Aug 28.
The need for donor pool expansion remains an important task for kidney transplantation. The aim of this study is the evaluation of primary nonfunction (PNF) from donation after circulatory death (DCD) kidneys.
Between 1996 and 2017, 100 kidney transplants from DCD donors were conducted in our department. We retrospectively analyzed PNF of kidney transplant recipients from DCD donors in terms of donors' and recipients' epidemiologic characteristics.
Of 100 grafts, 95 recipients (95.0%) had discontinued hemodialysis at the time of hospital discharge. Only 5 recipients (5.0%) developed PNF. All 5 PNF recipients received a single graft from an expanded criteria donor (ECD). The mean donor age in the PNF group was 65.0 (SD, 6.2) years. Significant differences between the PNF group and discontinued dialysis group were found for donor age (P < .01) and for the use of ECD kidneys (P < .02). Nevertheless, no significant difference was found between groups for several factors: a history of hypertension and cerebrovascular events, terminal creatinine levels, and graft weight.
The incidence of PNF from DCD kidneys was very low. Although ECD kidneys in older donors might be a significant risk factor for PNF, these findings suggest that DCD kidneys should be used more frequently for donor expansion.
扩大供体库的需求仍然是肾移植的一项重要任务。本研究旨在评估心脏死亡后器官捐献（DCD）肾移植的原发性无功能（PNF）情况。
1996年至2017年间，我科共进行了100例DCD供体肾移植。我们根据供体和受体的流行病学特征，对DCD供体肾移植受者的PNF进行了回顾性分析。
100例移植肾中，95例受者（95.0%）在出院时停止了血液透析。只有5例受者（5.0%）发生了PNF。所有5例PNF受者均接受了来自扩大标准供体（ECD）的单个移植物。PNF组供体的平均年龄为65.0（标准差，6.2）岁。PNF组与停止透析组在供体年龄（P <.01）和ECD肾的使用方面（P <.02）存在显著差异。然而，在高血压病史、脑血管事件、终末期肌酐水平和移植肾重量等几个因素上，两组之间未发现显著差异。
DCD肾移植的PNF发生率非常低。虽然老年供体的ECD肾可能是PNF的一个重要危险因素，但这些结果表明，DCD肾应更频繁地用于扩大供体库。
