Abstract:

Objective To analyze the short-term clinical effort of deceased donor（DD）kidney transplantation from donors with cardiopulmonary resuscitation（CPR）. Methods A retrospective analysis was performed in 8 deceased donors who underwent cardiopulmonary resuscitation from January 2018 to May 2019. Six donors implemented organ donation according to cardiac death standard due to irreversible cardiac death （Maastricht Ⅳ）， while two donors implemented organ donation according to the brain death standard after successful cardiopulmonary resuscitation. A total of 16 patients received kidney transplantation from these eight donors. Shortterm renal allograft function and recipient/graft survival rate were evaluated. DGF， IGF， SGF， acute rejection and pulmonary infection were followed up. Results During the follow-up period from 2 months to 18 months， the incidence of delayed graft function recovery （DGF）， immediate graft function recovery （IGF） and slow graft function recovery （SGF） were 56.25% （9/16），25%（4/16）， and 75%（12/16）. Two recipients showed primary graft non-function. The survival rate of recipients was 93.75% （15/16）， and the survival rate of death-censored recipients was 86.7%（13/15）. During the follow-up period， there was 1 case died of pulmonary infection and 2 cases experienced acute rejection. The lowest serum creatinine was （127±34）μmol/L in 14 patients with renal function recovery. Conclusion The incidence of DGF and SGF is high in patients who received kidney transplantation from CPR donors， meanwhile the function of transplanted kidney recovers very slowly. The short-term survival effect is acceptable; However， the long-term effect needs further follow-up observation.

摘要：

目的 分析心肺复苏供者供肾肾移植早期的临床效果。方法 回顾性分析 2018年 1月—2019年 5 月施行的死亡供者（deceased donor，DD）中，有心肺复苏经历供体 8 例，其中 6 例为不可控心死亡捐献 类型（马氏Ⅳ型），2 例心肺复苏成功后实施脑死亡器官捐献，共实施肾移植 16 例。随访评价短期移植肾功 能，受者 / 移植物短期存活率，并追踪移植物功能延迟恢复（delayed graft function，DGF）、移植物功能快速 恢复（immediate graft function，IGF）、移植物功能缓慢恢复（slow graft function，SGF）、急性排斥反应、肺 部感染发生率等资料。结果 截止到 2019 年 7 月，随访时间 2 ~ 18 月， DGF 发生率为 56.25% （9/16），IGF 发生率 25%（4/16），SGF 发生率 75%（12/16），2 例受者出现移植物原发无功能，受者生存率为 93.75%（15/16）， 剔除死亡受者移植肾生存率 86.7%（13/15），随访期内出现 1 例肺部感染死亡，2 例急性排斥反应。14 例肾 功能恢复患者血肌酐最低值为（127±34）μmol/L。结论 心肺复苏供体供肾移植术后 DGF、SGF 发生率较高， 移植肾功能恢复缓慢，短期存活效果可，其远期效果需要继续随访观察。