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乳酸林格氏液作为活体供肾移植中的保存液。

Lactated Ringer as Preservation Solution in Living Donor Renal Transplantation.

机构信息

Department of Nephrology, Sanko University Medical School, Gaziantep, Turkey.

Department of General Surgery, Sanko University Medical School, Gaziantep, Turkey.

出版信息

Transplant Proc. 2023 Jun;55(5):1134-1139. doi: 10.1016/j.transproceed.2023.04.031. Epub 2023 May 17.

Abstract

BACKGROUND

Optimal organ preservation remains a critical hallmark event in renal transplantation as it is the supply line. Previous studies have shown that the choice of preservation solution may affect transplant outcomes. In this study, we aimed to present the early follow-up results of the graft and patients, using lactated Ringer to preserve kidney allografts with living donors.

METHODS

The results of 97 living donor transplant operations performed in Sanko University Hospital were evaluated retrospectively. The patient's evaluation included demographics, dialysis time duration, renal replacement method, primary disease, comorbidity, surgical and clinical complications in the acute period, graft functions, blood levels of calcineurin inhibitor drugs, anastomotic renal artery, warm ischemia, and cold ischemia times.

RESULTS

Donor (49 men, 50.5%) and recipient (58 men, 59.7%) demographics, HLA compatibility (mismatch), hospitalization days, and length of warm and cold ischemic time are summarized in Table 1. Primary nonfunction was not defined in any patients, but delayed graft function was observed during the follow-up of 3 patients (3.09%), who were all hypotensive in the post-transplantation period, and positive inotropic infusion was needed for hemodynamic stability.

CONCLUSIONS

Lactated Ringer demonstrated efficacy in terms of patient and graft survival, and its lower cost represents a financial advantage, so it can be used in living donor kidney transplantation because it is safe, effective, and inexpensive. Standard preservation solutions may still be recommended in cases with long cold ischemia times, such as paired exchange transplants and cadaveric transplants. Thus, randomized controlled studies are needed for further investigation.

摘要

背景

在肾移植中,器官的最佳保存仍然是一个关键的标志事件,因为它是供应线。先前的研究表明,保存液的选择可能会影响移植结果。在这项研究中,我们旨在展示使用乳酸林格氏液保存活体供者的肾移植物的早期随访结果。

方法

回顾性评估了 Sanko 大学医院进行的 97 例活体供肾移植手术的结果。患者评估包括人口统计学、透析时间、肾脏替代方法、原发性疾病、合并症、急性期间的手术和临床并发症、移植物功能、钙调神经磷酸酶抑制剂药物的血液水平、吻合肾动脉、热缺血和冷缺血时间。

结果

供者(49 名男性,50.5%)和受者(58 名男性,59.7%)的人口统计学、HLA 相容性(不匹配)、住院天数以及热缺血和冷缺血时间的长短总结在表 1 中。在任何患者中均未定义原发性无功能,但在 3 名患者(3.09%)的随访中观察到延迟移植物功能,这些患者在移植后均出现低血压,需要正性肌力药物输注以维持血流动力学稳定。

结论

乳酸林格氏液在患者和移植物存活率方面表现出疗效,其较低的成本代表了经济优势,因此可以用于活体供者肾移植,因为它安全、有效且价格低廉。在冷缺血时间较长的情况下,如配对交换移植和尸体移植,仍可能推荐使用标准保存液。因此,需要进行随机对照研究进一步研究。

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