中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (18): 3280-3283.doi: 10.3969/j.issn.1673-8225.2011.18.013

• 器官移植临床实践 clinical practice of organ transplantation • 上一篇    下一篇

脑死亡器官捐献移植过程中的问题

王光策，王锁刚，张  翥，陈  铸，王文生，崔  勇   

  1. 河南中医学院第一附属医院肾病诊疗中心肾移植科，河南省郑州市   450003
  • 收稿日期:2010-11-09 修回日期:2011-03-22 出版日期:2011-04-30 发布日期:2011-04-30
  • 作者简介:王光策，男，1961年生，河南省淅川县人，蒙古族，1983年郑州大学医学院毕业，主任医师，教授，硕士生导师，主要从事肾移植的临床、科研及教学方面的研究。 wgc460@medmail.com.cn

Several problems in brain-dead donor kidney transplantation

Wang Guang-ce, Wang Suo-gang, Zhang Zhu, Chen Zhu, Wang Wen-sheng, Cui Yong   

  1. Department of Kidney Transplantation, the Nephrosis Center, First Affiliated Hospital of Henan Traditional Medical College, Zhengzhou  450003, Henan Province, China
  • Received:2010-11-09 Revised:2011-03-22 Online:2011-04-30 Published:2011-04-30
  • About author:Wang Guang-ce, Professor, Chief physician, Master’s supervisor, Department of Kidney Transplantation, the Nephrosis Center, First Affiliated Hospital of Henan Traditional Medical College, Zhengzhou 450003, Henan Province, China wgc460@medmail.com.cn

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438

被引次数

17

摘要：

背景：采用国际标准的供肾来源，即脑死亡无偿肾脏捐献可缓解目前肾移植中供肾的严重短缺问题。近年脑死亡无偿器官捐献及移植已在中国成功开始实施，但在脑死亡无偿器官捐献肾移植方面的报道较少。
目的：探讨脑死亡器官捐献肾移植在中国的可行性及保证移植成功的必要条件。
方法：总结2007-01/2010-07脑死亡器官捐献肾移植12例患者的经验和体会，包括供者/供肾的评估、供肾的摘取与保存、肾移植情况、移植后受者肾功能及并发症、住院时间、生活质量等。
结果与结论：12例脑死亡器官捐献肾移植受者中10例在移植后2~5 d肾功能恢复正常，移植后14~21 d出院；2例出现肾功能延迟恢复，分别于移植后10，15 d肾功能正常，移植后第28天出院。在2~42个月随访过程中，8例患者肾功能均正常，尿蛋白阴性，已从事正常工作，生活质量良好；2例出现蛋白尿，但肾功能正常；1例肾功能正常，肝功能异常，经治疗好转；1例在术后3个月死于严重肺部感染。提示，脑死亡器官捐献肾移植在中国可以得到开展；脑死亡供者必须有满意的血流动力学和尿量及良好的肾功能才能作为理想的肾移植供体；选择最佳移植时机，重视移植后系统性随访，才能确保脑死亡无偿器官捐献肾脏移植成功。

关键词: 脑死亡, 肾移植, 供肾, 器官捐献, 供体

Abstract:

BACKGROUND: Using the source of kidney up to the international standard, namely the kidney contributed freely by the cognitive death may alleviate the critical shortage in the present kidney transplant .In recent years ,the cognitive death organ contribution and the transplant have began to implant successfully in china ,but there are few reports about that.
OBJEECTIVE: To discuss the practicality of the cognitive death organ contribution kidney transplant in China and the essential condition to guarantee successful transplant. 
METHODS: Twelve patients’ experience in the cognitive death organ contribution for kidney transplant from 2007-01 to 2010-07 were summarized, including donor/for kidney’s appraisal for kidney's selecting and preservation, kidney transplant situation, transplant acceptor kidney function and complication, the time in hospital, quality of life and so on.
RESUITS AND CONCLUSION: In the 12 cases of cognitive death organ contribution kidney transplants, there were 10 patients’ kidney function recovering 2-5 days after the operation, and being discharged from hospital 14-21 days later. Two patients’ kidney function recovered slower relatively which became normal 10,15 days after transplanting separately and they were discharged from hospital on the 28th day. In 2-42 months revisiting, kidney function in 8 cases was normal, urinate protein was negative. They had been engaged in work normally and the quality of life was good; in 2 cases, urinate protein presented positive, but the kidney function was normal. One patient’s kidney function was normal, the liver function was unusual, while after treatment, it turned better; one case died of serious lung infection 3 months after operation. It indicates that the cognitive death organ contribution kidney transplant may obtain the development in China ; the cognitive death must have satisfactory blood stream dynamics, urine amount, good kidney function, who can be the ideal kidney donor; Choose the best transplant opportunity, attach importance to the systematic revisit. In this way, we can guarantee the success of cognitive death free organ contribution kidney transplants.

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