Study on Preservation and Survival of Cadaveric Renal Graft with Warm Ischemia

热缺血尸体肾移植物的保存和存活研究

• 批准号: 06454454
• 负责人: TAJIMA Atsushi
• 金额: $ 3.9万
• 依托单位: University of Tokyo
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (B)
• 财政年份: 1994
• 资助国家: 日本
• 起止时间: 1994 至 1995
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-06454454/
• 关键词: warm ischemia; cadaveric renal graft; simple cooling; organ preservation; cyclosporine; FK-506; heart massage; 死体腎移血; 温阻値

The objects of this study are as follows. 1) To find and establish a simple and easy method by which common physicians are able to preserve the cadaveric renal graft in cardiac arrest donors until a donation team arrives at a donor hospital. 2) To find markers that predict viability of the renal graft damaged by warm ischemia. 3) To decide an appropriate dosage of nephrotoxic immunosuppressant, cyclosporine or FK-506, in a recipient with a warm ischemia-damaged renal graft.From animal experiments and clinical observations, the following was induced. 1) Abdominal cooling of the cardiac arrest donor by ices and cold water is effective for renal preservation. 2) Bolus administration of heparin and steroid to the donor just after the cardiac arrest is also effective. 3) Aggressive and continuous heart manual massage of the cardiac arrest donor brings about good preservation. 4) Cold donor's abdominal cavity at laparotomy and smooth irrigation of the removed graft is good indicators of viability. 5) Combination immunosuppression of a half dosage of nephrotoxic cyclosporine or FK-506, azathioprine or mizoribine and antilymphocyte globulin is recommended in the severely damaged ATN graft.

本研究的对象如下：1)寻找并建立一种简单易行的方法，使普通医生能够将心脏骤停供体的尸体肾移植保存到捐赠团队到达供体医院。2)寻找预测热缺血肾移植损害的标志物。3)确定热缺血损伤肾移植受者肾毒性免疫抑制剂环孢素或FK-506的合适剂量。根据动物实验和临床观察，我们诱导了如下实验结果。1)冰和冷水对心脏骤停供者腹部降温对肾脏保存有效。2)心脏骤停后立即给供体注射肝素和类固醇也是有效的。3)对心脏骤停供者进行积极持续的心脏手动按摩，保存效果良好。4)剖腹时供体腹腔冷态和取出的移植物顺利冲洗是良好的生存指标。5)肾毒性环孢素或FK-506、硫唑嘌呤或米佐瑞滨联合半剂量免疫抑制和抗淋巴细胞球蛋白对严重损伤的ATN移植物有效。

项目成果

Tajima,A.,et al.: "Parathyroid function after Vidney allografting" Transplantation Proceedings(in press).

Tajima,A.,et al.：“Vidney 同种异体移植后的甲状旁腺功能”移植论文集（正在出版）。

Ishikawa, A., Tajima,A., et al.: "Immunossuppresive effect of lymphocytapheresis:Our experience with Haemonetics V50 apheresis system" Jpn J Apheresis. 14. 141-142 (1995)

Ishikawa, A.、Tajima,A. 等人：“淋巴细胞分离术的免疫抑制作用：我们使用 Haemonetics V50 单采系统的经验”Jpn J Apheresis。

Tajima, A., Kawabe, K.Aso, Y.: "Induction of immunossuppresive state by lymphocytopheresis in kidney allograft recipients" Transplantation Proceedings. 26. 2069-2071 (1994)

Tajima, A.、Kawabe, K.Aso, Y.：“肾同种异体移植受者通过淋巴细胞去除术诱导免疫抑制状态”移植论文集。

Tajima,A.,et al.: "Induction of immunossuppresive state by lymphocytopheresis in kidney allograft recipients" Transplantation Proceedings. 26. 2069-2071 (1994)

Tajima,A.,et al.：“同种异体肾移植受者通过淋巴细胞去除术诱导免疫抑制状态”移植论文集。

Tajima, A., Kawabe: "General examination and renal function test for tubulointerstitial nephropathy" Nihon Rinsho. 53. 1925-1930 (1995)

Tajima, A., Kawabe：“肾小管间质性肾病的一般检查和肾功能检查”Nihon Rinsho。