deceased供体肾移植患者移植肾功能延迟的风险：来自印度北部的单中心经验

Risk for Delayed Graft Function in Deceased Donor Renal Transplant Patients: A Single-Center Experience From North India.

作者信息

Seth Abhinav, Sharma Ashish, Kenwar Deepesh Benjamin, Patil Shivakumar S, Pandey Gaurav Shankar, Kallepalli Vidyasagar, Rally Sahil, Thakur Vivek, Mandwar Milind, Singh Sarbpreet

机构信息

Department of Renal Transplant Surgery, Nehru Building, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Transplant Proc. 2020 Jul-Aug;52(6):1741-1743. doi: 10.1016/j.transproceed.2020.04.003. Epub 2020 May 17.

DOI:10.1016/j.transproceed.2020.04.003

PMID:32434744

Abstract

OBJECTIVES

Delayed graft function (DGF) in renal allograft transplantation refers to the need for dialysis in the first week after renal transplantation. This study analyzed the causes of DGF in deceased donor transplantation.

METHODS

Data from January 2018 to July 2019 was reviewed with regard to donor and recipient characteristics such as demographics, biochemical parameters, organ dysfunction, and preterminal management. The recipients were divided into 2 groups: group I: patients without DGF and group II: patients with DGF.

RESULTS

Kidneys were retrieved from 49 deceased donors (male:female = 41:8) and transplanted to 95 recipients (male:female = 60:35). Mean age of the donors and recipients was 35.34 ± 18.2 and 40.72 ± 13.30 years, respectively. The most common cause of brain death was central nervous system trauma (45 out of 49, 91%). In total, 20/95 (21%) recipients had DGF. Twelve recipients had received kidneys from donors who had circulatory arrest. Two patients were re-explored on postoperative day 1 for bleeding from renal artery anastomosis. The mean age in group I and group II was 28.65 ± 10.2 and 37.38 ± 12.28 years, respectively. The mean cold ischemia time in group I and group II was 398.73 ± 187.19 and 333.24 ± 115.49 minutes, respectively. The mean hospital stay of donor before donation in group I and group II was 4.34 ± 1.27 and 6 ± 2.95 days, respectively. The terminal donor creatinine in group I and group II was 0.88 ± 0.47 and 2.33 ± 1.73 mg/dL, respectively.

CONCLUSION

DGF in deceased donor transplantation may be attributed to donation after circulatory death, prolonged donor hospital stay, high donor leukocyte count, and high terminal creatinine.

摘要

目的

肾移植中的移植肾功能延迟恢复（DGF）是指肾移植术后第一周需要进行透析。本研究分析了死亡供体移植中DGF的原因。

方法

回顾了2018年1月至2019年7月期间关于供体和受体特征的数据，如人口统计学、生化参数、器官功能障碍和临终前处理。将受体分为两组：第一组：无DGF的患者；第二组：有DGF的患者。

结果

从49例死亡供体（男:女 = 41:8）获取肾脏并移植给95例受体（男:女 = 60:35）。供体和受体的平均年龄分别为35.34±18.2岁和40.72±13.30岁。脑死亡最常见的原因是中枢神经系统创伤（49例中的45例，91%）。共有20/95（21%）的受体发生DGF。12例受体接受了来自发生循环骤停供体的肾脏。2例患者在术后第1天因肾动脉吻合口出血接受再次探查。第一组和第二组的平均年龄分别为28.65±10.2岁和37.38±12.28岁。第一组和第二组的平均冷缺血时间分别为398.73±187.19分钟和333.24±115.49分钟。第一组和第二组供体在捐献前的平均住院时间分别为4.34±1.27天和6±2.95天。第一组和第二组供体临终时的肌酐分别为0.88±0.47mg/dL和2.33±1.73mg/dL。