Clinical Research Of Perfusing Kidney From China Donation After Cardiac Death By LifePort

【Objective】Through monitoring the rate of DGF, and the parameter of s ICAM-1、SOD、MAD、creatinine、Cys C in renal transplant recipients by different ways of saving kidney china donation after cardiac death(CDCD), to explore the advantage of saving kidney donation after cardiac death by Life Port and summarize the experience in the use of Life Port.【Methods】To select 26 CDCD cases from 77 cases completed by Third Affiliated Hospital of Xiangya Medical School and The Second Hospital University of South China during January, 2015 to December, 2015. Saving one side of kidneys randomly by Life Port(Life Port team,n=26), the other side saving by communis cold storage(Cold storage team,n=26), then performing homogeneity variant renal transplantation. Using tacrolimus, mycophenolate mofetil, and prednisone for antirejection the rapy. Follow the patients for one mouth. During this period, detecting serum s ICAM-1, SOD, MDA and the value of creatinine and Cys C by double antibody sandwich ELISA to Observe the rate of DGF.【Results】1. To compare the value of s ICAM-1 in serum in every groupThe value of s ICAM-1 in serum elevated after the operation in Lifeport team, reached the peak level on the 3rd day(437±58ug/L) and decreased gradually in the following days, on the 14 th day achieved the level of stability, then no changes. Cold storage team followed the same trend, but the value is significantly higher(643±66 ug/L). The difference is statistically significant(P<0.05).2.To compare the activity of SOD in serum in every groupThe activity of SOD elevated after the operation in Lifeport team(114.53±5.93 IU/ml), and decreased gradually in the following days, then achieved the level before surgery on the 28 th day. Cold storage team followed the same trend, but the value is significantly lower(87.23±6.39 IU/ml). The difference is statistically significant(P<0.05).3.To compare the activity of MDA in serum in every groupThe activity of MDA elevated after the operation in Lifeport team(4.60±0.34 umol/l), and decreased gradually in the following days, then achieved the level before surgery on the 28 th day. Cold storage team followed the same trend, but the value is significantly higher(5.90±0.43 umol/l). The difference is statistically significant(P<0.05).4. To compare the value of Cr in serum in every groupThe value of Cr in serum decreased dramatically after the operation without DGF and AR. About two weeks after the operation the value back to normal and maintained at a steady level. When discharge from hospital the value in Lifeport team(118.38±24.40 umol/l) is significantly lower than in Cold storage team(143.08±31.79 umol/l). The difference is statistically significant(P<0.05).5. To compare the value of Cys C in serum in every groupThe value of Cys C in serum decreased dramatically after the operation without DGF and AR. About two weeks after the operation the value back to normal and maintained at a steady level. When discharge from hospital the value in Lifeport team(1.15±0.57 umol/l) is significantly lower than in Cold storage team(1.74±0.63 umol/l). The difference is statistically significant(P<0.05).6.The rate of DGFThere are 5 cases(5/26) of DGF in renal transplantation in Lifeport team, the rate is 19.2%. There are 12 cases(12/26) of DGF in renal transplantation in cold storage team, the rate is 46.2%, it is significantly higher in cold storage team than in Lifeport team. The difference is statistically significant(P<0.05).【Conclusion】1、The preservation effect of Life Port on CDCD was significantly better than that of conventional storage.2、Lifeport can reduce the expression of s ICAM-1 and the oxygen-derived free radicals produced mainly by CDCD donor kidneys and accelerating the oxygen-derived’s metabolism to lower the ischemia-reperfusion injury of donor kidneys, which to protect the quality of the kidney simultaneously and prevent postoperative complications after kidney transplantation.