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机器灌注保存对非心脏跳动供体肾脏延迟性移植物功能的影响——早期结果

Effect of machine perfusion preservation on delayed graft function in non-heart-beating donor kidneys--early results.

作者信息

Daemen J H, de Vries B, Oomen A P, DeMeester J, Kootstra G

机构信息

Department of Surgery, University Hospital, Maastricht, The Netherlands.

出版信息

Transpl Int. 1997;10(4):317-22. doi: 10.1007/s001470050063.

Abstract

The functioning of non-heart-beating (NHB) donor kidneys upon transplantation is often delayed. To evaluate the effect of preservation by machine perfusion (MP) on early post-transplant function, 37 NHB donor kidneys were compared to 74 matched heart-beating (HB) donor kidneys preserved by cold storage (CS). The NHB donor kidneys were subject to 49 +/- 34 min of warm ischemia. Delayed function (DF) and primary nonfunction (PNF) rates were significantly higher for NHB than for HB donor kidneys (49% and 19% vs 34% and 7%, respectively). Consequently, renal function was impaired but recovered within 6 months. MP could not eliminate the differences in DF rate between NHB and HB donor kidneys. However, NHB donor kidneys preserved by MP showed less DF than that reported in kidneys preserved by CS. This suggests that MP has a beneficial effect on ischemically damaged kidneys. The similar results observed with category 2 and category 3 NHB donors also suggest this effect. The high PNF rate emphasizes the need for viability tests that prevent the transplantation of nonviable organs. We conclude that MP alone is not sufficient to reduce DF and PNF rates in NHB donor kidneys.

摘要

非心跳(NHB)供体肾脏移植后的功能通常会延迟。为了评估机器灌注(MP)保存对移植后早期功能的影响,将37个NHB供体肾脏与74个匹配的采用冷藏(CS)保存的心跳(HB)供体肾脏进行了比较。NHB供体肾脏经历了49±34分钟的热缺血。NHB供体肾脏的延迟功能(DF)和原发性无功能(PNF)发生率显著高于HB供体肾脏(分别为49%和19%,而HB供体肾脏分别为34%和7%)。因此,肾功能受损,但在6个月内恢复。MP不能消除NHB和HB供体肾脏在DF发生率上的差异。然而,采用MP保存的NHB供体肾脏的DF发生率低于采用CS保存的肾脏的报告发生率。这表明MP对缺血损伤的肾脏有有益作用。在2类和3类NHB供体中观察到的类似结果也表明了这种作用。高PNF发生率强调了需要进行活力测试以防止移植无活力器官。我们得出结论,单独使用MP不足以降低NHB供体肾脏的DF和PNF发生率。

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