实用器官移植电子杂志

实用器官移植电子杂志 ›› 2020, Vol. 8 ›› Issue (6): 446-450.DOI: 10.3969/j.issn.2095-5332.2020.06.008

• 论著 • 上一篇    下一篇

DCD 供肾移植术后1 年内受者移植肾丢失原因分析（附50 例临床报道）

李超1，柏宏伟1，石炳毅1，李钢1，解俊杰1，谢晓媚2，张杉杉3，刘炎忠1   

  1. 1. 中国人民解放军总医院第八医学中心泌尿二科，北京 100091 ；  2. 滨州医学院，山东滨州 256603 ；  3. 湖北中医药大学，湖北 武汉 430065
  • 出版日期:2020-11-20 发布日期:2021-06-25

Analysis of the causes of transplanted kidney loss in recipients within 1 year after DCD donor kidney transplantation（ 50 clinical reports attached）

Li Chao1，Bai Hongwei1，Shi Bingyi1，Li Gang1，Xie Junjie1，Xie Xiaomei2，Zhang Shanshan3，Liu Yanzhong1.
  

  1. 1. The SecondDepartment of Urology，the Eighth Medical Center of the Chinese People's Liberation Army General Hospital，
    Beijing100091，China ；
    2. Binzhou Medical College，Shandong Binzhou 256603，China ；
    3. Hubei University of TraditionalChinese Medicine，Hubei Wuhan 430065，China
  • Online:2020-11-20 Published:2021-06-25

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摘要：

目的 探讨心脏死亡器官捐献（donation after cardiac death，DCD）肾移植术后早期（术后1 年以内）受者移植肾丢失的原因。方法 回顾性分析50 例DCD 供肾移植术后早期移植肾丢失受者的临床资料。结果 受者移植肾丢失50 例，移植肾丢失的原因包括排斥反应19 例（38.0%）、受者带移植肾功能死亡17 例（34.0%）、移植肾血管并发症5 例（10.0%）、供体来源泛耐药肺炎克雷伯杆菌（carbapenem-resistant Klebsiella pnermoniae，CRKP）感染4 例（8.0%）、原发性无功能肾4 例（8.0%）、旧肾原发病（膜性肾病）复发1 例（2.0%）。DCD 供肾移植术后1 年内受者移植肾丢失的主要原因为排斥反应，次要原因为受者带功能死亡、移植肾血管并发症、原发性无功能肾、耐药菌感染，旧肾原发病复发少见。结论 总结DCD 供肾移植术后早期移植物丢失的原因，为器官移植医师提供临床参考，从而有针对性地加强防治，进一步提高DCD 供肾移植1 年成功率，减少因患者及家属的不满而引起的医疗纠纷。

关键词:

Abstract:

Objective To investigate the causes of kidney graft loss in early stage （within 1 yearafter surgery） in recipients with donation after cardiac death （DCD） kidney transplantation. Methods A retrospective analysis of the clinical data of 50 recipients with early kidney graft loss after DCD donor kidneytransplantation was performed. Results 50 recipients lost transplanted kidneys. The causes of kidney loss included19 rejections（38.0%），17 deaths（34.0%）with normal transplanted kidney function，5 vascular complications of transplanted kidneys（10.0%），4 cases ofcarbapenem-resistant Klebsiella infection（8%），4 cases of primary non-functioning kidney（8.0%），and 1 case of recurrence of primary kidney disease（2.0%）. The main reason for the lossof the transplanted kidney in the recipient within 1 year after the DCD donor kidney transplantation is rejection，and the secondary cause is the death of the recipient with normal renal function，complications of the transplanted kidney，primary non-functional kidney，and drug-resistant infection. Recurrence of the primary disease of the diseased kidney was rare. Conclusion Summarizing the reasons for early graft loss after DCD donor kidney transplantationis to provides reference for organ transplant physicians to strengthen targeted prevention and treatment. Ultimately，it may increase the 1-year survival of DCD donor kidney transplantation and reduce the dissatisfaction or medicaldispute caused by patients and their families.

Key words: Kidney transplantation, Donation after cardiac death, Transplanted kidney failure

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