机械灌注应用在肾移植中的效果评价(附36例报道)

目的探讨机械灌注法保存供肾的临床效果。方法 2013年5月至10月,解放军第181医院肾脏科采用机械灌注保存供肾共36例。采用LKT-100型Lifeport器官灌注运输器及其配套专用的相关软件进行机械灌注保存、运输、灌注供肾。分析患者术后一般情况,机械灌注过程中阻力系数和流速与移植物功能延迟恢复(DGF)发生的关系。结果 36例受者均未发生移植肾丢失。其中30例(83%)未发生DGF,移植肾功能恢复良好;6例出现DGF,经治疗术后3~18 d逐渐恢复正常。36例供肾进行机械灌注1 h,阻力系数≤0.3 mmHg/(ml·min)28例,受者术后均未发生DGF;阻力系数0.3 mmHg/(ml·min)8例,其中6例受者术后发生DGF。8例流速100 ml/min,受者均未发生DGF;21例流速60~100 ml/min,其中有1例受者发生DGF;7例流速60 ml/min,其中5例发生DGF。结论机械灌注法保存供肾能改善供肾质量,降低移植受者的DGF发生率。

Effect evaluation of mechanical perfusion in the application of renal transplantation： a report of 36 cases

Objective To explore the clinical effect of mechanical peffusion for preserving kidney. Methods From May to October 2013, 36 donors＇ kidneys were preserved by mechanical perfusion in the Department of Kidney in the 18F＇ Hospital of Chinese People＇s Liberation Army. The donors＇ kidneys were preserved, transported and peffused by the LKT-100 type Lifeport organ transporter and special software. General condition of patients and the relationship between resistance coefficient, flow velocity and occurrence of delayed graft function （DGF） were analyzed. Results None of 36 recipients had graft loss. Thirty cases＇ （83%） renal function recovered well without DGF. Six cases developed DGF and returned to normal gradually after 3-18 days postoperative treatment. After mechanical renal perfusion for 1 h, 28 recipients with kidneys＇ resistance coefficient ≤ 0. 3 mmHg/ （ml ·min ） hadn＇t developed DGF after transplantation. Among 8 recipients with kidneys＇ resistance coefficient 〉 0. 3 mmHg/ （ml ·min） , 6 recipients developed DGF. Eight recipients with kidneys＇ flow velocity 〉 100 ml/min hadn＇t developed DGF. Among 21 recipients with kidneys＇ flow velocity 60-100 ml/min, 1 case developed DGF. In 7 recipients with kidneys＇ flow velocity 〈 60 ml/min, 5 cases developed DGF. Conclusions Mechanical perfusion for preserving kidney can improve graft quality and reduce the incidence of DGF in recipients.