摘要
目的探讨低温机械灌注与冷保存应用于心脏死亡器官捐赠（DCD）供肾的效果差异，为临床DCD供肾选取最佳保存方式提供依据。方法计算机检索中国知网、中国生物医学文献、维普中文科技期刊、万方数据知识服务平台、PubMed、EMbase、Ovid、EBSCO数据库，检索时间均为2000年1月至2014年12月，同时检索相关文献的参考文献，纳入所有低温机械灌注与冷保存在DCD供肾效果分析的随机对照试验、病例对照试验及回顾性队列分析，应用Review Manager软件对资料进行荟萃分析。结果10篇文献纳入荟萃分析，低温机械灌注组1590例，冷保存组1834例。低温机械灌注组的受者移植肾功能延迟恢复发生率低（比值比=0．49，95％可信区间为0．30～0．80，P=0．004）。两组原发性肾脏无功能发生率的差异无统计学意义（比值比=1．55，95％可信区间为0．54～4．42，P=0．41）且移植后1年移植肾存活率的差异也无统计学意义（比值比=0．79，95％可信区间为0．37～1．69，P=0．54）。结论在DCD供肾移植中，低温机械灌注的保存方式优于冷保存，但其改善保存效果的能力有限。
Objective To compare the effect of hypothermic machine perfusion （HMP） vs. cold storage （CS） in kidney transplantation from donation after cardiac death, so as to provide the basis for clinical application. Method Such databases as CNKI, CBMdisc, VIP, Wanfang, PubMed, EMbase, Ovid and EBSCO were searched from January 2000 to December 2014 for collecting the randomized controlled trials （RCTs）, case control studies and cohort analysis about the outcomes in patients receiving DCD kidneys preserved by HMP or by CS preservation. At the same time, the relevant literature references were also retrieved. The meta-analysis was conducted by using Review Manager5. 3 software. Result Ten publications, involving 1590 HMP and 1834 CS preserved DCD kidney transplant recipients, were included, HMP preserved DCD kidney transplant recipients had a decreased incidence of delayed graft function （DGF） （OR = 0. 49, 95% CI 0. 30-0. 80, P = 0. 004） compared to CS. However, there were no significant differences between the twotechnologies in incidence of primary non-function （OR = 1.55, 95% CI 0. 54-4. 42, P = 0. 41） and one-year graft survival （OR = 0. 79, 95M CI 0. 37-1.69, P = 0. 54）. Conclusion In kidney transplantion from donation after cardiac death, HMP preservation is superior to CS, but the improving effect of preservation is limited.
出处
《中华器官移植杂志》
CAS
CSCD
2015年第4期225-230,共6页
Chinese Journal of Organ Transplantation
基金
国家自然科学基金重点项目（U1403222）
武汉市科学科技攻关项目（2013060602010247）
武汉大学医学部协同创新项目
关键词
肾移植
器官保存
低温保存
Kidney transplantion
Organ preservation
Cryopreservation
