【摘要】 目的探讨中国公民逝世后器官捐献(Chinese donation after citizens’death,CDCD)发生肾移植功能延迟恢复(delayed graft function,DGF)的预后因素。方法回顾性分析2014年1月~2015年11月在武汉大学中南医院138例行同种异体肾移植手术的临床资料,21例发生DGF(DGF组),117例移植肾功能稳定(immediate graft function,IGF)为IFG组,采用χ~2检验进行单因素分析,再用logistic模型对有统计学差异的因素进行多因素分析。结果 DGF发生率为15.2%(21/138),单因素分析显示DGF的预后因素包括受者术前血透时间≥12个月(P=0.024)、脑出血死亡供者(P=0.020)、供者血清肌酐≥177μmol/L(P=0.013)、热缺血时间≥15 min(P=0.041)、冷缺血时间≥12 h(P=0.025)及供者经历心肺复苏(P=0.001)有显著性差异。logistic多因素分析显示供者血清肌酐≥177μmol/L(OR=7.138,95%CI:1.418~35.937,P=0.017)、供者心肺复苏(OR=30.207,95%CI:3.653~111.778,P=0.001)及热缺血时间≥15 min(OR=7.762,95%CI:1.953~30.845,P=0.004)是DGF的独立预后因素。结论供者血清肌酐≥177μmol/L、供者经历心肺复苏及热缺血时间≥15 min是导致CDCD发生DGF的预后因素。更多还原

【Abstract】 Objective To evaluate the prognostic factors of delayed graft function( DGF) of kidney transplantation after Chinese donation after citizens ’ death( CDCD). Methods We retrospectively analyzed the clinical data of 138 subjects who underwent a CDCD kidney transplantation at our hospital from January 2014 to November 2015. We classified the recipients into IGF( immediate graft function) group( n =117) and DGF group( n =21),and analyzed the relationship of DGF and factors of donors and recipients by χ~2 test and logistic regression. Results The total rate of DGF was 15. 2%( 21/138). In the univariate analysis,preoperative dialysis time of recipients ≥ 12 months( P = 0. 024),death from cerebral hemorrhage( P = 0. 020),preoperative serum creatinine of donors ≥ 177 μmol/L( P = 0. 013),warm ischema time( WIT) ≥ 15 min( P = 0. 041),cold ischema time( CIT) ≥12 h( P = 0. 025),and donors experience of cardio-pulmonary resuscitation( CPR)( P = 0. 001) showed significant differences. In the multivariate analysis,preoperative serum creatinine of donors ≥ 177 μmol/L( OR = 7. 138,95% CI: 1. 418-35. 937,P = 0. 017),donors experience of CPR( OR = 30. 207,95% CI: 3. 653-111. 778,P = 0. 001),warm ischema time ≥ 15 min( OR = 7. 762,95%CI: 1. 953-30. 845,P = 0. 004) were independent prognostic factors for DGF development. Conclusion The independent prognostic factors for DGF are preoperative serum creatinine of donors ≥ 177 μmol/L,donors experience of CPR and warm ischema time ≥ 15 min.更多还原