Short-term Outcome Of 50 Cases Of Kidney Transplantations From Expanded Criteria Donors And Clinical Analysis Of Early Kidney Graft Loss From Donation After Citizens’ Death Donors

Part I Short-term Outcome of 50 cases of Kidney transplantations from Expanded Criteria DonorsObjective:Bay now in our china donation after citizen death will be the major sources of donor pool in kidney transplantation.We compared short-term outcome(1 year)of kidney transplantation from expanded criteria donors(ECD)with the standard criteria donors(SCD).Method: From January 1,2013 to December 31,2014,our hospital reported 108 cases of CDCD organ donation.From those donors they had prove 190 s kidney for transplantation,including 50 cases of ECD renal transplantation and 140 cases of SCD renal transplantation in the same period.We compared the early graft recovery(The percentage of patients in IGF,SGF,DGF)and one year survival rate after transplantation in both two group.Result: The ECD group had 28 cases categorized into IGF,8 cases categorized into SGF,14 cases categorized into DGF by one week after transplantation.The SCD group had 67 cases categorized into IGF,22 cases categorized into SGF,51 cases categorized into DGF the same time.The 1-year survival rate of recipients and graft survival rate was 92%、90% in ECD group and 94.3% 、91.4% in SCD group.The differences were not statistically significant(P>0.05).ECD group in 1,3,6 and 12 mouth post surgery the serum creatinine and e GFR average from 137.4mmol/L、107.6mmol/L、100.5mmol/L、104.4mmol/L;69.9m L/(min·1.73 m2)、78.5m L/(min·1.73 m2)、86.3m L/(min·1.73 m2)、83.7m L/(min·1.73 m2)。While the SCD group average from 115.2mmol/L、99.1mmol/L、93.0mmol/L、83.3mmol/L(P<0.05);82.2m L/(min·1.73 m2)、88.3m L/(min·1.73 m2)、93.8m L/(min·1.73 m2)、102.1m L/(min·1.73 m2).The differences has statistically significant(P<0.05).Conclusion: While ECD was worse than SCD in transplant renal function(serum creatinine level and e GFR).But there was no significant difference in the early stage of renal transplantation between ECD and SCD,and the reasonable use of ECD for kidney can be an important way to deal with the shortage of organs.But the long-term graft survival should be explored in further follow-up.Part Ⅱ Clinical Analysis of Early Kidney Graft Loss From Donation after Citizen Death DonorsObjective: By analyze the incidence and etiology of early renal graft loss in current donation after citizen death.Then try to explore the way to prevention and treatment of early graft loss after kidney transplantation.Method: A retrospective review study was implemented to analyze the CDCD kidney transplantation in our hospital from Jan 01 2013 to December 31,2015.Result: In our hospital the early renal graft loss rate was 1.32%(1/76)in 2013;7.8%(12/154)in 2014;4.12%(12/291)in 2015.The renal graft hemorrhage 13/25(52%)has become a main risk of early graft loss,other risk is lung infection 4/25(16%)and cerebrovascular accident 3/25(12%).However,Hemorrhage due to vascular rupture of transplanted kidney caused by infection has become the main reason 8/13(61.5%).Conclusion: Effective prevention and prompt treatment for renal graft hemorrhage will significantly reduce the rate of early renal graft loss and improve the prognosis of patients.But also the mediciner should be alert to the occurrence of donor source infection.