摘要目的 总结和探讨死亡后器官捐献(DD)供肾的质量评估及肾移植的预后.方法 回顾性分析2011年12月至2018年8月期间577例DD供者及其1084例肾移植的临床资料.通过多方面综合评估供者和供肾质量,总结和分析移植预后.并根据供者评分情况分为＜5分组、5～15分组、15～30分组及＞30分组四组,观察和比较四组受者和移植肾的存活率以及术后急性排斥反应(AR)、移植肾功能恢复延迟(DGF)及感染的发生率等,比较移植肾功能恢复的时间.结果 577例供者中,“中国二类”116例,“中国三类”461例;＜5分259例、5～15分486例、15～30分306例及＞30分33例;1 084例DD供者供肾移植受者术后随访时间为(14.3±13.5)个月,术后DGF发生率为12.7％,AR发生率为7.2％,感染发生率为24.9％,术后1、3年受者存活率分别为97.4％和92.1％,移植肾存活率分别为94.6％和89.2％.各组间术后1、3年受者和移植肾存活率的差异均有统计学意义(P＜0.05);随着评分的增加,术后AR、DGF及感染等发生率均显著增加(P＜0.05),肾功能恢复的时间也显著延长(P＜0).05).结论 对DD供者和供肾质量进行综合评估能够确保肾移植的总体效果.

abstractsObjective To investigate the influence of quality evaluation of donated kidney after citizen's death on prognosis of renal allograft recipients.Methods A retrospective analysis on 577 cases of deceased organ donation/1084 cases of renal transplantation was made in the First Affiliated Hospital of Xi'an Jiaotong University from December 2011 to August 2018.The quality of donor/ donated kidney was evaluated through various aspects,and the prognostic data of renal transplant recipients were summarized and analyzed.Results 1 084 cases of donated kidney transplantation were completed,and the average follow-up time was (14.3 ± 13.5) months.The 1-and 3-year survival rate of transplant recipients was 97.4％ and 92.1％,respectively,and the 1-and 3-year survival rate of transplanted kidney was 94.6％ and 89.2％ respectively.There were significant differences in human/ kidney survival rate and DGF incidence after renal transplantation among those various groups according to the criteria of subdivision of score of points for donor assessment.Conclusion Comprehensive evaluation of donated kidney quality in all aspects has a significant positive effect on improving the effect of transplantation.