Machine perfusion versus cold storage of kidneys derived from donation after cardiac death: a meta-analysis.
Machine perfusion versus cold storage of kidneys derived from donation after cardiac death: a meta-analysis.
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心脏死亡后捐献肾脏的机器灌注与冷藏：一项荟萃分析。
DOI：
10.1371/journal.pone.0056368
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
He X
中科院分区：
文献类型：
--
作者：
Deng R;Gu G;Wang D;Tai Q;Wu L;Ju W;Zhu X;Guo Z;He X
为了应对日益严重的器官短缺问题，心脏死亡（DCD）捐献者捐献的器官再次成为临床移植中可接受的选择。然而，使用 DCD 器官的移植结果不如脑死亡后捐赠或活体捐赠者的移植结果好。不同的器官保存方法是影响DCD肾移植效果的关键因素。我们通过荟萃分析比较了接受机器灌注 (MP) 或静态冷藏 (CS) 保存的 DCD 肾脏的患者的移植结果。检索了 MEDLINE、EMBASE 和 Cochrane 图书馆数据库。所有报告 MP 与 CS 保留 DCD 肾脏结果的研究均进一步考虑纳入本荟萃分析。计算优势比和 95% 置信区间 (CI)，以比较 MP 或 CS 保存的肾脏移植组之间的汇总数据。纳入了四项前瞻性、随机、对照试验，涉及 175 名 MP 和 176 名 CS 保留的 DCD 肾移植受者。与 CS 相比，保存 MP 的 DCD 肾移植受者的移植物功能延迟 (DGF) 发生率降低，奇数比为 0.56（95% CI= 0.36–0.86，P = 0.008）。然而，两种技术在原发性无功能发生率、一年移植物存活率或一年患者存活率方面没有显着差异。在降低移植后 DGF 率方面，DCD 肾脏的 MP 保存优于 CS。然而，使用 MP 或 CS 进行保存不会影响原发性无功能、一年移植物存活率和一年患者存活率。
In response to the increased organ shortage, organs derived from donation after cardiac death (DCD) donors are becoming an acceptable option once again for clinical use in transplantation. However, transplant outcomes in cases where DCD organs are used are not as favorable as those from donation after brain death or living donors. Different methods of organ preservation are a key factor that may influence the outcomes of DCD kidney transplantation. We compared the transplant outcomes in patients receiving DCD kidneys preserved by machine perfusion (MP) or by static cold storage (CS) preservation by conducting a meta-analysis. The MEDLINE, EMBASE and Cochrane Library databases were searched. All studies reporting outcomes for MP versus CS preserved DCD kidneys were further considered for inclusion in this meta-analysis. Odds ratios and 95% confidence intervals (CI) were calculated to compare the pooled data between groups that were transplanted with kidneys that were preserved by MP or CS. Four prospective, randomized, controlled trials, involving 175 MP and 176 CS preserved DCD kidney transplant recipients, were included. MP preserved DCD kidney transplant recipients had a decreased incidence of delayed graft function (DGF) with an odd ration of 0.56 (95% CI = 0.36–0.86, P = 0.008) compared to CS. However, no significant differences were seen between the two technologies in incidence of primary non-function, one year graft survival, or one year patient survival. MP preservation of DCD kidneys is superior to CS in terms of reducing DGF rate post-transplant. However, primary non-function, one year graft survival, and one year patient survival were not affected by the use of MP or CS for preservation.
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影响因子：
2.1
作者：
Cantafio, A. W.;Dick, A. A. S.;Perkins, J. D.
通讯作者：
Perkins, J. D.
影响因子：
11.4
作者：
MARSHALL, VC;ROSS, H;KINCAIDSMITH, PS
通讯作者：
KINCAIDSMITH, PS
影响因子：
0.9
作者：
Moustafellos, P.;Hadjianastassiou, V.;Friend, P. J.
通讯作者：
Friend, P. J.
影响因子：
0.9
作者：
van der Vliet, JA;Kievit, JK;Kootstra, G
通讯作者：
Kootstra, G
影响因子：
8.8
作者：
Groen, H.;Moers, C.;Buskens, E.
通讯作者：
Buskens, E.