【摘要】：目的：探討公民逝世后心臟死亡供體(Donation after citizen's deceased, DCD)的移植腎腎功能延遲恢復(fù)(Delayed Graft Function,DGF)發(fā)生的危險(xiǎn)因素及預(yù)后情況。 方法：收集我中心及武漢中南醫(yī)院2010年2月至2012年6月的56例DCD腎移植受者,分為DGF組(n=23)及腎功能穩(wěn)定組(Immediate Graft Function, IGF)(n=33)。分析發(fā)生DGF的危險(xiǎn)因素及DGF對(duì)移植物及受者生存的影響。 結(jié)果：DGF的發(fā)生率為41.1%,在單因素分析中DCD供體BMI≥24.9kg/m2(P0.001),死亡原因?yàn)樽园l(fā)性疾病(P=0.027),術(shù)前肌酐≥2mg/dL(P0.001),術(shù)前使用去甲腎上腺素(P0.001)；受體術(shù)前透析類型為血液透析(P=0.039),術(shù)前透析時(shí)間≥12月(P0.001)；移植相關(guān)因素中HLA錯(cuò)配位點(diǎn)≥3(P0.001),熱缺血時(shí)間≥15min(P0.001).冷缺血時(shí)間≥6h(P0.001)為DGF的危險(xiǎn)因素,在多因素分析中,受體術(shù)前透析時(shí)間≥12月(P=0.011,HR：31.690)、腦出血死亡供體(P=0.052,HR：13.319)、熱缺血時(shí)間≥15分鐘(P=0.004,HR：44.948)為DGF獨(dú)立的危險(xiǎn)因子。DGF的發(fā)生并未對(duì)受者(P=0.061)及移植物(P=0.055)的存活造成影響。在出院后的隨訪中,隨訪中位時(shí)間為9.25個(gè)月(0.4-27月),DGF組的受者移植物3個(gè)月、6個(gè)月、1年、18個(gè)月的存活率為86.1%,80.7%,75.3%,75.3%,受者的存活率為90.0%,84.4%,78.8%,78.8%；IGF組的受者移植物3個(gè)月、6個(gè)月、1年、18個(gè)月的存活率為87.9%,84.5%,84.5%,84.5%,受者的存活率為100%,96.3%,96.3%,96.3%。 結(jié)論：本研究中DGF的獨(dú)立危險(xiǎn)因子是受體術(shù)前透析時(shí)間≥12月、熱缺血時(shí)間≥15分鐘、腦出血死亡供體,DGF并未對(duì)DCD腎移植受者及移植物的生存造成負(fù)面影響。
[Abstract]:Objective: to investigate the risk factors and prognosis of delayed recovery of renal function in patients with cardiac death donor (Donation after citizen's deceased, DCD) (Delayed Graft Function,DGF) after death. Methods: from February 2010 to June 2012, 56 cases of DCD renal transplant recipients in our center and Wuhan Central and South Hospital were divided into two groups: DGF group (n = 23) and stable renal function group (Immediate Graft Function, IGF) (nong33). To analyze the risk factors of DGF and the influence of DGF on the survival of grafts and recipients. Results the incidence of DCD was 41.1%. In univariate analysis, the BMI of DCD donor was 鈮，

本文編號(hào)：2253001