肝肾联合移植后前列地尔的早期应用

背景：近来有文献报道，前列地尔可促进移植肾功能的恢复，降低肾功能恢复延迟与急性排斥反应发生率，减少死亡率。 目的：观察肝肾联合移植后早期应用前列地尔对移植物功能恢复的影响。 方法：选择6例肝肾联合移植患者作为实验组，移植过程中及移植后3周内给予前列地尔30 μg/d，同期选择4例移植过程中及移植后不给予前列地尔的肝肾联合移植患者作为对照。观察两组患者移植后尿量、血肌酐、肌酐清除率、丙氨酸氨基转移酶、天冬氨酸转移酶、总胆红素、直接胆红素、移植肾血流阻力指数、胆汁引流量情况。 结果与结论：实验组患者移植后尿量、肌酐清除率、胆汁引流量均大于对照组(P < 0.05)，丙氨酸氨基转移酶、天冬氨酸转移酶、总胆红素、直接胆红素浓度、肌酐浓度及移植肾血流阻力指数均明显低于对照组(P < 0.05)。结果证实前列地尔对肝肾联合移植后移植肝、肾功能的早期恢复有积极的意义。

Early application of alprostadil after combined liver and kidney transplantation

BACKGROUND:Recently the literature has been reported that alprostadil can promote the recovery of graft function and reduce delayed recovery of renal function, acute rejection rate, and mortality. OBJECTIVE:To observe the effect of the early application of alprostadil after combined liver and kidney transplantation on graft function recovery. METHODS:A total of 6 cases of combined liver and kidney transplantation patients were selected as experimental group who were given alprostadil 30 μg/d during transplantation and 3 weeks after transplantation. Four cases of combined liver and kidney transplantation patients were selected as control group who were not given alprostadil during transplantation and after transplantation. Urine output, serum creatinine, creatinine clearance, alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, renal vascular resistance index, and biliary drainage volume of patients between two groups after transplantation were observed. RESULTS AND CONCLUSION:The urine output, creatinine clearance, biliary drainage volume of patients in experimental group after transplantation was higher than that of control group (P < 0.05). Alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin concentration, creatinine concentration, and renal vascular resistance index was lower than that of control group (P  < 0.05). The results have confirmed that alprostadil has a positive significance in the early recovery of transplanted liver and kidney function after combined liver and kidney transplantation.