加速康复外科在肾移植患者中的应用：贝尔法斯特方案。

Application of Enhanced Recovery After Surgery in Patients Undergoing Kidney Transplant: the Belfast Protocol.

机构信息

Department of Renal Surgery, Regional Nephrology Unit, Belfast Health and Social Care Trust, Belfast City Hospital, Belfast, United Kingdom.

出版信息

Transplant Proc. 2021 Sep;53(7):2204-2205. doi: 10.1016/j.transproceed.2021.07.046. Epub 2021 Aug 26.

DOI:10.1016/j.transproceed.2021.07.046

PMID:34456045

Abstract

BACKGROUND

The aim of this study was to assess the impact of the Belfast Protocol for enhanced recovery after surgery on hospital length of stay (LOS) after kidney transplant.

METHODS

A prospectively collected database was analyzed for all consecutive renal transplant recipients in 2010 and compared with consecutive renal transplant recipients in 2018 before and immediately after the full implementation of the Belfast Protocol.

RESULTS

There were 73 renal transplants in 2010 and 115 in 2018. Between 2010 and 2018 there was a significant decrease in LOS from 12 to 7 days (P < .0001). Compared with 2010, in 2018 there was a significant increase in donor age (47 vs 54 years, P < .0001) and kidney transplant from donation after circulatory death donors (0% vs 9%, P < .0001). Although there was no change in the proportion of living donors (59% vs 50%, P = .32), in 2018 there were more blood group incompatible living donors (0% vs 7%, P = .21). Compared with 2010, in 2018 there was a significant increase in recipient age (43 vs 54 years, P = .0002), diabetic nephropathy (5% vs 16%, P = .03), and recipient body mass index >35 kg/m2 (0% vs 9%, P = .02).

CONCLUSIONS

Implementation of the Belfast Protocol has decreased LOS in renal transplant recipients despite increasingly complex donor and recipient profiles.

摘要

背景

本研究旨在评估增强手术后恢复的贝尔法斯特议定书对肾移植后住院时间（LOS）的影响。

方法

分析了 2010 年所有连续肾移植受者的前瞻性收集数据库，并与 2018 年在完全实施贝尔法斯特议定书之前和之后连续肾移植受者进行了比较。

结果

2010 年有 73 例肾移植，2018 年有 115 例。2010 年至 2018 年，LOS 从 12 天显著缩短至 7 天（P<0.0001）。与 2010 年相比，2018 年供体年龄（47 岁比 54 岁，P<0.0001）和来自心脏死亡供体的肾移植显著增加（0%比 9%，P<0.0001）。尽管活体供者的比例没有变化（59%比 50%，P=0.32），但 2018 年有更多的血型不相容的活体供者（0%比 7%，P=0.21）。与 2010 年相比，2018 年受者年龄（43 岁比 54 岁，P=0.0002）、糖尿病肾病（5%比 16%，P=0.03）和受者体重指数>35 kg/m2（0%比 9%，P=0.02）显著增加。