中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (5): 899-902.doi: 10.3969/j.issn.1673-8225.2010.05.033

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

脑死亡无偿器官捐献肾移植6例

许  亮，蔡  明，李州利，王  强，钱叶勇，石炳毅   

  1. 解放军第三○九医院全军器官移植中心泌尿一科，北京市  100091
  • 出版日期:2010-01-29 发布日期:2010-01-29
  • 通讯作者: Cai Ming, Chief physician, First Department of Urology, Organ Transplantation Center, 309th Hospital of Chinese PLA, Beijing 100091, China caiming@medmail.com.cn
  • 作者简介:许 亮★，男，1983年生，安徽省舒城县人，汉族，2008年解放军总医院－军医进修学院毕业，硕士，医师，主要从事器官移植、泌尿外科临床与基础研究。 xul351@sina.com
  • 基金资助:

    全军“十一五”计划科技攻关课题(06G115)资助。

 Renal transplantation using brain death free-donated kidney in 6 cases

Xu Liang, Cai Ming, Li Zhou-li, Wang Qiang, Qian Ye-yong, Shi Bing-yi   

  1. First Department of Urology, Organ Transplantation Center, 309th Hospital of Chinese PLA, Beijing  100091, China
  • Online:2010-01-29 Published:2010-01-29
  • Contact: 蔡 明，主任医师，解放军第三○九医院全军器官移植中心泌尿一科，北京市 100091 caiming@ medmail.com.cn
  • About author:Xu Liang★, Master, Physician, First Department of Urology, Organ Transplantation Center, 309th Hospital of Chinese PLA, Beijing 100091, China xul351@sina.com
  • Supported by:

    he Military Eleventh Five-Year Tackle Program in Science and Technology, No. 06G115*

PDF

658

被引次数

36

摘要：

背景：脑死亡的器官是最佳器官移植供体，因为需移植的器官可以在有血供的情况下从供体上直接取得，有助于移植后移植物功能的早期恢复。而中国对脑死亡的研究起步较晚，且对于尿毒症患者接受脑死亡供者移植后的恢复情况至今国内尚无文献报道。
目的：总结6例尿毒症患者接受脑死亡无偿器官捐献肾移植的治疗经验及效果。
方法：选择解放军第三○九医院全军器官移植中心2006-05/2008-11尿毒症患者6例，其中2例接受1例院内脑死亡患者的无偿供肾，4例患者接受3例院外脑死亡患者的无偿供肾。所有受者移植后均采用三联免疫抑制方案，环孢素+吗替麦考分酯+类固醇激素4例，他克莫司+吗替麦考分酯+类固醇激素2例，规律复查移植肾功能及药物浓度，回顾性分析移植肾功能的恢复情况及病情变化。
结果与结论：6例患者均顺利接受脑死亡供体肾脏移植，顺利渡过围手术期；5例在移植后1周内血肌酐下降明显，移植肾开始工作。1例移植后出现移植肾功能延迟恢复，移植后10 d逐渐恢复正常。3例在移植后1年内出现急性排异反应，经激素冲击治疗后尿量恢复，血肌酐水平稳定。1例移植后1年出现肺部重症感染，治疗无效死亡，死亡时移植肾肌酐为469 µmol/L。其余5例定期接受复查，随访至今移植肾肌酐稳定，生活质量良好。结果提示脑死亡无偿器官捐献肾移植后肾功能可得到及时恢复，患者生活质量得到明显改善。

关键词: 脑死亡, 肾移植, 肾功能, 器官移植, 供体

Abstract:

BACKGROUND: Brain death patient is the optimal donator due to the short warm ischemia time, which is conductive to renal function recover following transplantation. However, there are no reports concerning the recovery of renal function in uremia patients following renal transplantation with brain death patients’ kidney. 
OBJECTIVE: To summarize the experience and therapeutic efficacy of renal transplantation using brain death free-donated kidney.
METHODS: Six patients with urinemia underwent renal transplantation with donor kidney of brain death patients from May 2006 to November 2008 at the Organ Transplantation Center, 309th Hospital of Chinese PLA, were selected, including 2 patients receiving kidneys from a brain death patient, 4 patients receiving kidneys from 3 brain death patients. Four recipients received immunosuppressive regimen of mycophenolate+ciclosporin+steroid, and 2 recipients received mycophenolate+ acrolimus+steroid. The renal function and medicine density were detected regularly, and change of renal function and pathogenetic condition were retrospective analyzed.
RESULTS AND CONCLUSION: All 6 patients accepted renal transplantation successfully. The serum creatinine level was obvious descended in 5 patients within a week after transplantation, which meant that the transplanted kidney had begun to work. One patient suffered delayed renal graft function, and returned to normal at 10 days after transplantation. Three patients suffered acute rejection in the first year, and recovered by intravenous glucocorticoid therapy. One patient died after 1 year for pulmonary infection, which accompanied by serum creatinine of 469 µmol/L. The other patients reexamined regularly, and they had good quality of life up to now. The results reveled that renal function recovers in time after transplantation using brain death free-donated kidney, which can ameliorate life quality of patients.

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