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

本研究的对象如下。1)寻找并建立一种简单易行的方法，使普通医生能够在心脏骤停供者的尸体肾移植中保存肾，直到供肾小组到达供肾医院。2)寻找预测热缺血损伤的移植肾存活的标志物。3)为确定肾毒性免疫抑制剂环孢素（cyclosporine）或FK-506（FK-506）在移植肾热缺血损伤中的适宜剂量，通过动物实验和临床观察，得出以下结论：1)用冰块和冷水对心脏骤停供者进行腹部降温是有效的肾脏保护方法。2)在心脏骤停后立即给予肝素和类固醇也是有效的。3)积极和持续的心脏手动按摩的心脏骤停供体带来良好的保存。4)剖腹手术时供体腹腔温度较低，取出的移植物冲洗顺畅，是存活的良好指标。5)对严重受损的ATN移植物，建议采用半量肾毒性环孢素或FK-506、硫唑嘌呤或咪唑立宾和抗淋巴细胞球蛋白联合免疫抑制。

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.