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目的:探讨终末期肾病患者接受心脏死亡无偿器官捐献(DCD)供者移植后的恢复情况及此类供体对受者及移植物术后的影响。方法:对48例终末期肾病患者接受DCD捐献的肾脏后行同种异体肾移植术,并对其术前和术后的诊疗及随访血肌酐、移植物及受者存活情况进行回顾性分析。结果:48例受者中无1例出现移植肾原发性无功能(PNF),18例受者术后出现肾功能延迟恢复(DGF),其发生率为37.5%,DGF组与无DGF组受者及移植肾生存率比较,差异无统计学意义(分别P=0.098,P=0.447)。48例受者中有7例(14.6%)受者移植肾丢失,其他41例受者随访时间为0.5~23(中位数8)个月,39例(95.1%)受者移植肾功能恢复正常。在1,3,6,12个月移植物的存活率分别为95.7%,93.0%,90.0%,87.5%,患者的存活率分别为100%,94.9%,90.0%,87.5%。结论:在我国尚无脑死亡法的环境下,DCD是解决我国器官移植界瓶颈的重要手段,是器官来源的重要部分,并且有着较好的短中期预后。
Objective: To investigate the recovery of end-stage renal disease patients receiving donor-donated cardiac death (DCD) donor grafts and the effects of such donors on recipients and graft surgery. Methods: Forty-eight patients with end-stage renal disease received kidney donation from DCD. Allograft kidney transplantation was performed. Preoperative and postoperative diagnosis and follow-up of serum creatinine, graft and recipient survival were retrospectively analyzed. Results: None of the 48 recipients had primary renal failure (PNF). Delayed recovery of renal function (DGF) was observed in 18 of the 18 recipients, with a rate of 37.5%. DGF and no DGF There was no significant difference in the survival rate of recipients and transplant recipients (P = 0.098, P = 0.447, respectively). Among the 48 recipients, 7 (14.6%) recipients lost their transplant kidneys, and 41 others were followed up for 0.5 to 23 (median 8) months. In 39 (95.1%) recipients, graft function recovered normal. Survival rates of grafts at 1, 3, 6 and 12 months were 95.7%, 93.0%, 90.0% and 87.5%, respectively. Survival rates of patients were 100%, 94.9%, 90.0% and 87.5%, respectively. Conclusion: Under the circumstance that there is no brain death law in our country, DCD is an important means to solve the bottleneck of organ transplantation in our country, an important part of organ source, and has a good short-term prognosis.