A Randomized Double Blind Controlled Trial Of Continuous Low Temperature Perfusion By Urokinase On Renal Function Of CDCD

【Objective】compare save mode the rate of DGF,the parameter of CR、Cys C in renal transplant recipients by different ways of saving kidney china donation after cardiac death(CDCD),to explore the effect of saving kidney donation after cardiac death by Urokinase continuous hypothermic perfusion preservation and summarize the experience in of Urokinase continuous hypothermic perfusion preservation.And though observation and the Kim-1、the parameter of s TM、HSP70 in patient urine,to explore the possible mechanism of action.【Methods】Using randomized double-blind principle To select 24 CDCD cases fro-m 66 cases completed by The Second Hospital University of South China d-uring January,2014 to February,2017.According to the principle of rand-o m distribution,each donor Bilateral kidneys was divided into two groups.Di vided into two groups of AB,group A saving by Continuois hypothermic p erfusion with urokinase(Urokinase team,n=24),group B saving by commun-is i hypothermic perfusion storage(conventional storageteam,n=24),After proc-es sing performing homogeneity variant renal transplantation.Using mycophen-olate mofetiltacrolimus,and prednisone for antirejection the rapy.Observe t-he patients recovered within 1 months after operation.observated the param-et er of Cr、Cys C in serum after operation and 24 hour urine volume、po-st operative DGF incidence of Two groups recipients.During this period,reg-u larly Collect patient venous blood,detecting different time periods recipie-n t s TM and HSP70 H creatinine;And collect urine regularly,detecting dif-f erent time periods recipientn Urine Kim-1 content by double antibody sandwich ELISA.【Results】In clinical indicators,the urinary volume of urokinase group in the same peri od after operation was higher than that in normal perfusion group.The difference i s statistically significant(P < 0.05).The serum Cr level in patients of the urokinase group in the same period after operation was lower than that in the normal group,The difference is statistically significant(P<0.05),The mean value of Cys C in the urokinase group in the same period after operation was lower than that in the normal group,then gradually decreased to normal level,The difference is statistically significant(P<0.05),By the 21 day both gradually tend to normal,The difference was not statistically significant(P > 0.05);Postoperative,the number of DGF cases in the urokinase group was significantly less than that in the normal perfusion group,the difference is statistically significant(P<0.05).In mechanism indexme,The urinary kim-1 in the urokinase group peaked at the first day after operation,the kim-1 value of urokinase group in the same period was lower than that in the normal group,then gradually decreased,the difference is statistically significant(P<0.05),By the 28 day both gradually tend to normal level,the difference was not statistically significant(P>0.05);The serum s TM level of urokinase group reached peak in third days after operation,the s TM value of urokinase group in the same period was lower than that in the normal group,then gradually decreased,the difference is statistically significant(P<0.05),By the 21 day both gradually tend to normal level,The difference was not statistically significant(P>0.05);The serum HSP70 level of urokinase group peaked at the first day after operation,the HSP70,value of urokinase group in the same period was lower than that in the normal group,then gradually decreased,the difference is statistically significant(P<0.05),By the 28 day both gradually tend to normal level,the difference was not statistically significant(P>0.05).【Conclusion】1.The preservation effect of Urokinase continuous hypothermic perfusion preservation on CDCD was significantly better than that of conventional storage.2.Continuous hypothermic perfusion of urokinase can reduce CDCD donor kidneys thrombosis after warm ischemia,though reduce renal perfusion,devreased reperfusion injury of vascular endothelium,reduce renal tubular injuryre,reduce inflammation reaction and apoptosis to lower the ischemia-reperfusion injury,which to protect the quality of the kidney simultaneously and prevent postoperative complications after kidney transplantation.